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NPI Code Detail

MEDICARE: CAROLE MOORE JUDD

MEDICARE: CAROLE MOORE JUDD
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
1374U00000XHome Health Aide

General Provider Information

NPI Number : 1730076746
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLE MOORE JUDD
Provider Business Mailing Address
First Line : 5432 MORNING DOVE LN
Second Line :
City : CROSS LANES
State : WV
Zip : 25313-1111
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5432 MORNING DOVE LN
Second Line :
City : CROSS LANES
State : WV
Zip : 25313-1111
Country : US
Telephone Number : 304-421-5210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2025
Last Update Date : 06/23/2025

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Directions to “ CAROLE MOORE JUDD ” Practice Location

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