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NPI Code Detail

MEDICARE: MRS. JUDY MENZ RN-C, FNP

MEDICARE: MRS. JUDY MENZ RN-C, FNP
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
1363LF0000XFamily Nurse Practitioner045140MO
2363LP0200XPediatric Nurse Practitioner045140MO

General Provider Information

NPI Number : 1538264072
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JUDY MENZ RN-C, FNP
Provider Business Mailing Address
First Line : 123 SMITH AVE
Second Line :
City : SIKESTON
State : MO
Zip : 63801-5239
Country : US
Telephone Number : 573-471-0200
Fax Number : 573-471-7559
Provider Business Practice Location Address
First Line : 123 SMITH AVE
Second Line :
City : SIKESTON
State : MO
Zip : 63801-5239
Country : US
Telephone Number : 573-471-0200
Fax Number : 573-471-7559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 04/01/2014

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