Judith Grace Fetters, ARNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

A004744 Issued in AR

Practice address

325 S 6TH PL
Lowell, AR 72745-9704

Phone

(479) 636-9234

Fax

(479) 717-7557

NPI assigned

Feb 27, 2007

Last updated

Aug 3, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1578690756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 S 6TH PL",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727459704",
            "telephone_number": "479-636-9234",
            "fax_number": "479-717-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 S 6TH PL",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727459704",
            "telephone_number": "479-636-9234",
            "fax_number": "479-717-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETTERS",
        "first_name": "JUDITH",
        "middle_name": "GRACE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AR",
            "license": "A004744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Edwards, SLP
• Johnny Victor Elmurr II, DC
• Diane Denice Erickson, LCSW
• Kathleen M Farrar
• Kaitlyn Felder, MS DT
• Imelda Rosas Flores
• Katelyn Ivy Forbis Roth
• Chad Dwain Ford
• David B. Fort Jr., M.D.
• Robin Lianne Forward-Wise, M.D.

• Pediatric Nurse Practitioner in Lowell, AR
• Providers in Lowell, AR by specialty
• Pediatric Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2016; 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.