Provider Demographics
NPI:1154399442
Name:ALLARD, JUDITH E (CRNA)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:ALLARD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 PINELLAS POINT DR S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-5850
Mailing Address - Country:US
Mailing Address - Phone:727-743-7610
Mailing Address - Fax:
Practice Address - Street 1:2370 PINELLAS POINT DR S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-5850
Practice Address - Country:US
Practice Address - Phone:727-743-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2677452367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRN2677452OtherFLORIDA RN LICENSE #