MEDICARE: MS. JUDIE PRUETT 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
1	363LA2100X	Acute Care Nurse Practitioner	960965	DC
2	363LA2200X	Adult Health Nurse Practitioner	960965	DC
3	363LG0600X	Gerontology Nurse Practitioner	960965	DC

General Provider Information

NPI Number	:	1457453888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDIE PRUETT NP

Provider Business Mailing Address
First Line	:	DEPARTMENT OF STATE
Second Line	:	M-MED-QI 2401 E ST NW
City	:	WASHINGTON
State	:	DC
Zip	:	20522-0102
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	DEPARTMENT OF STATE
Second Line	:	M-MED-QI 2401 E ST NW
City	:	WASHINGTON
State	:	DC
Zip	:	20522-0102
Country	:	US
Telephone Number	:	202-663-2453
Fax Number	:	202-663-1661

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	10/29/2007

Similar Medicare Providers

1295726859 — MRS. LAURA MICHELLE INGRUM NP-C
Practice Location Address:

M/MED/QI, SA-1 , US DEPARTMENT OF STATE
WASHINGTON, DC
20522-0102

Practice Phone: 202-663-1519
Practice Fax: 260-496-8077

1063482784 — NICHOLAS JOHN RIESLAND MD
Practice Location Address:

2401 E STREET NW , OFFICE OF MEDICAL SERVICES, US DEPARTMENT OF STATE
WASHINGTON, DC
20522-0102

Practice Phone: 202-663-1649
Practice Fax: 202-663-1613

1962464024 — KIP EDWARD QUEENAN MD
Practice Location Address:

2401 E STREET M/MED/DMD/QM SA-1
WASHINGTON, DC
20522-0102

Practice Phone: 202-663-1534
Practice Fax:

1609824739 — MR. STUART ALAN RICHARDS PA-C
Practice Location Address:

US DEPT OF STATE MED Q1 SA 1
WASHINGTON, DC
20522-0102

Practice Phone: 202-663-1519
Practice Fax: 202-663-3247

1922019108 — DR. BARRY FISHER MD
Practice Location Address:

US DEPT OF STATE MED QI SA 1
WASHINGTON, DC
20522-0102

Practice Phone: 202-663-1519
Practice Fax: 202-663-1456

1376645747 — DR. KIMBERLY KAYE OTTWELL M.D.
Practice Location Address:

U.S. DEPARTMENT OF STATE M/MED/QI, SA-1
WASHINGTON, DC
20522-0102

Practice Phone: 202-663-2453
Practice Fax: 202-663-3247

Directions to “ MS. JUDIE PRUETT NP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.