Provider Demographics
NPI:1548250160
Name:SUTTON, JUDY ANN (FNP-C)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:ANN
Last Name:SUTTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2201
Mailing Address - Street 2:
Mailing Address - City:EL PRADO
Mailing Address - State:NM
Mailing Address - Zip Code:87529-2201
Mailing Address - Country:US
Mailing Address - Phone:575-779-4950
Mailing Address - Fax:
Practice Address - Street 1:137 EARTHSHIP WAY
Practice Address - Street 2:
Practice Address - City:TRES PIEDRAS
Practice Address - State:NM
Practice Address - Zip Code:87577
Practice Address - Country:US
Practice Address - Phone:575-779-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2011-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR55581363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily