Provider Demographics
NPI:1962787259
Name:MCDOWELL, JUDITH ELKINGTON
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:ELKINGTON
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:MCDOWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:1005 VICTORIA ST
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:WY
Mailing Address - Zip Code:82801-3448
Mailing Address - Country:US
Mailing Address - Phone:307-752-1584
Mailing Address - Fax:
Practice Address - Street 1:1005 VICTORIA ST
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:WY
Practice Address - Zip Code:82801-3448
Practice Address - Country:US
Practice Address - Phone:307-752-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-18
Last Update Date:2017-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT29637163W00000X
PARN225404L163W00000X
WY18564.1130363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse