Glen I Judd

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

360342-3102 Issued in UT

Practice address

323 W Haleys Lookout
Elk Ridge, UT 84651-4564

Phone

(801) 472-2452

NPI assigned

Jul 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1346449428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 W HALEYS LOOKOUT",
            "city": "ELK RIDGE",
            "state": "UT",
            "postal_code": "846514564",
            "telephone_number": "801-472-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 W HALEYS LOOKOUT",
            "city": "ELK RIDGE",
            "state": "UT",
            "postal_code": "846514564",
            "telephone_number": "801-472-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDD",
        "first_name": "GLEN",
        "middle_name": "I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-17",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "663310",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "360342-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared Curtis, MD
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• Glen R Gabler, M.D.
• Linda Greco, CSW-I
• Renew Counseling
• Alexis D. Richardson
• Ross D. Frandsen LLC
• Bradley David Tuckett, PA-C

• Registered Nurse in Elk Ridge, UT
• Providers in Elk Ridge, UT by specialty
• Registered Nurse in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; 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.