MEDICARE: MS. JUDITH TERESA YURGEL PMHNP

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	163W00000X	Registered Nurse	612838	CA
2	163W00000X	Registered Nurse	044437	OR
3	363L00000X	Nurse Practitioner	14058	CA
4	363L00000X	Nurse Practitioner	27	OR
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP5989	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	Z144374	OTHER	AZ	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679659916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JUDITH TERESA YURGEL PMHNP

Provider Business Mailing Address
First Line	:	PO BOX 86537
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85754-6537
Country	:	US
Telephone Number	:	520-721-1887
Fax Number	:	520-372-7126

Provider Business Practice Location Address
First Line	:	107 E 4TH ST
Second Line	:
City	:	ELOY
State	:	AZ
Zip	:	85131-2506
Country	:	US
Telephone Number	:	520-466-7765
Fax Number	:	520-466-4475

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

Provider Enumeration Date	:	10/30/2006
Last Update Date	:	12/17/2020

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