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NPI Code Detail

MEDICARE: MRS. JUDITH NILSEN CUDWORTH NP

MEDICARE: MRS. JUDITH NILSEN CUDWORTH NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner11304NC

General Provider Information

NPI Number : 1114027273
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUDITH NILSEN CUDWORTH NP
Provider Business Mailing Address
First Line : 208 SUNSET CIR
Second Line :
City : HERTFORD
State : NC
Zip : 27944-9259
Country : US
Telephone Number : 252-338-4400
Fax Number :
Provider Business Practice Location Address
First Line : 711 ROANOKE AVE
Second Line :
City : ELIZABETH CITY
State : NC
Zip : 27909-5643
Country : US
Telephone Number : 252-338-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 07/08/2007

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