Provider Demographics
NPI:1316156490
Name:BYRNES, JUDITH ANNE (CDE)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ANNE
Last Name:BYRNES
Suffix:
Gender:F
Credentials:CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 KAY BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-2316
Mailing Address - Country:US
Mailing Address - Phone:401-849-2976
Mailing Address - Fax:
Practice Address - Street 1:1 RIGGS RD.
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:RI
Practice Address - Zip Code:02841-1002
Practice Address - Country:US
Practice Address - Phone:401-841-6774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI14780163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator