Provider Demographics
NPI:1215266028
Name:AUDETTE, JUDY ANN (RN)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:AUDETTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2787 RT 44
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05037
Mailing Address - Country:US
Mailing Address - Phone:802-674-5637
Mailing Address - Fax:
Practice Address - Street 1:2787 RTE 44
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:VT
Practice Address - Zip Code:05037-9754
Practice Address - Country:US
Practice Address - Phone:802-674-5637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0014375163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0400XNursing Service ProvidersRegistered NurseRehabilitation