Basic Information
| Provider Information | |||||||||
| NPI: | 1861684862 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEST | ||||||||
| FirstName: | JUDY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2868 ACTON RD | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352432502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059688360 | ||||||||
| FaxNumber: | 2059688361 | ||||||||
| Practice Location | |||||||||
| Address1: | 207 HAVEN DR | ||||||||
| Address2: | |||||||||
| City: | DOTHAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 363012919 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3347931964 | ||||||||
| FaxNumber: | 3347944131 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2007 | ||||||||
| LastUpdateDate: | 08/14/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 1-043681 | AL | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.