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NPI Code Detail

MEDICARE: JUDE NJI ABAM

MEDICARE:   JUDE NJI ABAM
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 PractitionerAP142111TX

General Provider Information

NPI Number : 1699337881
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDE NJI ABAM
Provider Business Mailing Address
First Line : 213 TIMBERLINE DR
Second Line :
City : MIDLOTHIAN
State : TX
Zip : 76065-5611
Country : US
Telephone Number : 832-215-0223
Fax Number :
Provider Business Practice Location Address
First Line : 1011 N COOPER ST
Second Line :
City : ARLINGTON
State : TX
Zip : 76011-5517
Country : US
Telephone Number : 832-215-0223
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2019
Last Update Date : 09/05/2020

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Directions to “ JUDE NJI ABAM ” Practice Location

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