Provider Demographics
NPI:1588864581
Name:VARDY, JUDITH LYNNE (C-FNP)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:LYNNE
Last Name:VARDY
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:MRS
Other - First Name:JUDITH
Other - Middle Name:LYNNE
Other - Last Name:VARDY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:C-FNP
Mailing Address - Street 1:US DEPARTMENT OF STATE M/MED/QI
Mailing Address - Street 2:2401 E. ST, NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20522-0001
Mailing Address - Country:US
Mailing Address - Phone:202-663-1919
Mailing Address - Fax:202-663-1454
Practice Address - Street 1:US DEPARTMENT OF STATE M/MED/QI
Practice Address - Street 2:2401 E. ST, NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20522-0001
Practice Address - Country:US
Practice Address - Phone:202-663-1919
Practice Address - Fax:202-663-1454
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA24064964363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily