Judith Tabaczka, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704173975 Issued in MI

Practice address

535 1St St
Manistee, MI 49660-1569

Phone

(231) 723-5550

NPI assigned

Apr 25, 2014

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1398384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1588084818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 1ST ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496601569",
            "telephone_number": "231-723-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 1ST ST",
            "city": "MANISTEE",
            "state": "MI",
            "postal_code": "496601569",
            "telephone_number": "231-723-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABACZKA",
        "first_name": "JUDITH",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-25",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704173975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan A Sullivan, MD
• Judy Superczyski
• Renae Sutton, RDN
• Thomas M Swedenborg, CRNA
• Allison Marie Swiastyn, PHARM D
• Kevin Tabaczka, PT
• Teter Orthotics & Prosthetics Inc
• Dori L Tetzlaff
• The Cedars Rehabilitation Center
• Theodore N Batzer MDPC

• Registered Nurse in Manistee, MI
• Providers in Manistee, MI by specialty
• Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.