Provider Demographics
NPI:1124162342
Name:WALDROUP, JUDITH C (MASTERS IN EDUCATION)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:C
Last Name:WALDROUP
Suffix:
Gender:F
Credentials:MASTERS IN EDUCATION
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:M
Other - Last Name:CATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASTERS IN EDUCATION
Mailing Address - Street 1:3701 BELLEMEADE AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47714-0137
Mailing Address - Country:US
Mailing Address - Phone:812-479-1411
Mailing Address - Fax:812-437-2636
Practice Address - Street 1:3701 BELLEMEADE AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47714-0137
Practice Address - Country:US
Practice Address - Phone:812-479-1411
Practice Address - Fax:812-437-2636
Is Sole Proprietor?:No
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN516576373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist