Individual provider Active NPI

Amanda Faith Judice, BSN, RN, IBCLC

  • Registered Nurse
  • Youngsville, LA
National Provider Identifier
1205420536
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN119297 Issued in LA
Practice address
146 Windermere Cir
Youngsville, LA 70592-5633
Phone
(225) 281-6315
NPI assigned
Feb 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X L-11025 LA
Registered Nurse 163W00000X RN119297 LA Primary

Addresses

Primary practice location

146 Windermere Cir
Youngsville, LA 70592-5633

Mailing address

PO Box 69
Youngsville, LA 70592-0069
Phone (225) 281-6315

Other identifiers 1

IdentifierTypeStateIssuer
0OtherN/A

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL n/a

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN119297LAMDRegistered Nurse
L-11025LAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1205420536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 69",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705920069",
            "telephone_number": "225-281-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 WINDERMERE CIR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925633",
            "telephone_number": "225-281-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDICE",
        "first_name": "AMANDA",
        "middle_name": "FAITH",
        "name_prefix": "Ms.",
        "credential": "BSN, RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "LA",
            "license": "L-11025",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN119297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "currently paper only",
            "address_1": "146 Windermere Cir",
            "city": "Youngsville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705925633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Youngsville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.