Provider Demographics
NPI:1215238449
Name:JUDON, LASHOUNDA ANN (HOME HEALTH AID)
Entity type:Individual
Prefix:
First Name:LASHOUNDA
Middle Name:ANN
Last Name:JUDON
Suffix:
Gender:F
Credentials:HOME HEALTH AID
Other - Prefix:
Other - First Name:LASHOUNDA
Other - Middle Name:ANN
Other - Last Name:JUDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:HOME HEALTH AID
Mailing Address - Street 1:4411 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967
Mailing Address - Country:US
Mailing Address - Phone:772-646-1037
Mailing Address - Fax:
Practice Address - Street 1:4411 25TH AVE
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32967-1380
Practice Address - Country:US
Practice Address - Phone:772-646-1037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL163WH0200X163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health