Provider Demographics
NPI:1093047292
Name:ARMGARDT, JUDITH BOWMAN (RD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:BOWMAN
Last Name:ARMGARDT
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 SECOND ST SE
Mailing Address - Street 2:377TH MEDICAL GROUP /SGPZ
Mailing Address - City:KIRTLAND AIR FORCE BASE
Mailing Address - State:NM
Mailing Address - Zip Code:87117-5522
Mailing Address - Country:US
Mailing Address - Phone:505-853-0637
Mailing Address - Fax:
Practice Address - Street 1:2050 SECOND ST SE
Practice Address - Street 2:377TH MEDICAL GROUP /SGPZ
Practice Address - City:KIRTLAND AIR FORCE BASE
Practice Address - State:NM
Practice Address - Zip Code:87117-5522
Practice Address - Country:US
Practice Address - Phone:505-853-0637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM726096133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered