Provider Demographics
NPI:1871694836
Name:ELGIN, JUDITH ELLEN (APRN,BC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ELLEN
Last Name:ELGIN
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:120 SUNSET PT
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38571-3679
Mailing Address - Country:US
Mailing Address - Phone:931-456-9664
Mailing Address - Fax:931-456-9664
Practice Address - Street 1:120 SUNSET PT
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38571-3679
Practice Address - Country:US
Practice Address - Phone:931-456-9664
Practice Address - Fax:931-456-9664
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000007516363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology