Judith Burnham, RN
Individual provider Active NPI Registered Nurse · Mountain City, TN
NPI 1811217490 · NPPES record last updated Jun 7, 2010
Key facts
- NPI
- 1811217490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 174361 (TN)
- Practice address
- 1902 Sprucey Ridge Private Rd
Mountain City, TN 37683-6210 - Phone
- (423) 418-4189
- NPI assigned
- Jun 7, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 174361 | TN | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 174361 | TN | Yes |
Addresses
Primary practice location
1902 Sprucey Ridge Private Rd
Mountain City, TN 37683-6210
Mailing address
1902 Sprucey Ridge Private Rd
Mountain City, TN 37683-6210
Phone (423) 418-4189
Other providers in Mountain City, TN
- Boone Drugs Inc
- Brightside ABA Inc
- Devon Brown
- Mica Lauren Brown
- Alric Wesley Burleson
- Nicholas C Bush Jr.
- Dereck G Campbell
- Millie Campbell
- Sarah W Campbell
- Connected Chiropractic and Wellness
All providers in Mountain City, TN · Registered Nurse in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 7, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.