MS. ELIZABETH MULLANPHY JUDD (NPI# 1629021597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629021597 |
| Entity Type | Individual |
| Full Name | MS. ELIZABETH MULLANPHY JUDD |
| Credential | CPNP, PMHS |
| Practice Address |
255 Spencer Rd Ste 201 Saint Peters MO 63376-2576 |
| Mailing Address |
660 S Euclid Ave C B 8134 Saint Louis MO 63110-1010 |
| Practice Telephone | 6369392550 |
| Practice Fax Number | 6369392551 |
| Mailing Telephone | 3142861700 |
| Mailing Fax Number | 3142861777 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-01-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
1999140595 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 364SP0810X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Family |
1999140595 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 427439906 | 05 | |
| IL | ENROLLED | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073689329 | Elizabeth Anne Judd | Physical Therapist | 7301 Georgetown Rd Suite 111, Indpls, IN 46268 | 2006-11-28 |
| 1881927960 | Elizabeth Judd | Physical Therapist | 2 Keewaydin Dr, Salem, NH 03079-2839 | 2009-09-08 |
| Street Address |
255 SPENCER RD STE 201 |
| City | SAINT PETERS |
| State | MO |
| Zip Code | 63376-2576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396721353 | Jerry L. Marks | Social Worker | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2005-12-21 |
| 1467062646 | Christian Hoffman | Nurse Practitioner | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2020-08-03 |
| 1083245351 | Angel Kramer | Counselor | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2020-01-27 |
| 1649733932 | James Andrew Adams | Nurse Practitioner | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2019-04-12 |
| 1063977247 | Mark Thomas Hale | Social Worker | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2019-02-01 |
| 1154895308 | Rachel Lee Kranz | Clinical Nurse Specialist | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2019-01-21 |
| 1780167478 | Stacia Woods | Nurse Practitioner | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2018-09-10 |
| 1871097642 | Cassidy Chapman | Nurse Practitioner | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2018-03-19 |
| 1013343904 | Diane Rene Appal | Counselor | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2013-09-24 |
| 1942540745 | Kelley Erin Johnson | Nurse Practitioner | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2013-02-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275047946 | Nicholas Christian Schultz | Dentist | 100 Piper Hill Dr Ste A, Saint Peters, MO 63376 | 2017-11-16 |
| 1982120093 | Carol Weber | Speech-Language Pathologist | 166 Boone Hills Dr., St Peters, MO 63376 | 2017-08-21 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1508310632 | Preferred Family Healthcare, Inc. | Counselor | 2120 Parkway Dr, Saint Peters, MO 63376 | 2016-08-05 |
| 1598130676 | Delta Center Personal Attendant Services | In Home Supportive Care | 3833 Mcclay, Suite 61, St. Peters, MO 63376 | 2015-12-01 |
| 1427420314 | Barbara Marlene Edelman | Counselor | 1286 Jungerman Rd. Suite G, St. Peters, MO 63376 | 2015-10-30 |
| 1255740247 | Claire Williams | Dentist | 340 Mid Rivers Mall Drive, Suite E, St. Peters, MO 63376 | 2014-08-05 |
| 1184042855 | Keith Wickenhauser | Internal Medicine | 201 Bjc Saint Peters Dr Ste 100, Saint Peters, MO 63376 | 2014-03-31 |
| 1821415233 | Abby Link | Physician Assistant | 107 Piper Parkway, #150, St. Peters, MO 63376 | 2014-03-24 |
| 1225452105 | Ashley Gagel | Physical Therapist | 7055 Mexico Rd Suite 1601, St. Peters, MO 63376 | 2014-02-12 |
| Find all providers in zip 63376 | ||||
| Taxonomy Code | 364SP0810X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Psych/Mental Health, Child & Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154895308 | Rachel Lee Kranz | Clinical Nurse Specialist | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2019-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134627730 | Yasmine King Fehr | Clinical Nurse Specialist | 9979 Winghaven Blvd Ste 202, O Fallon, MO 63368-3628 | 2018-01-29 |
| 1497282008 | Gwendolyn Broyles | Clinical Nurse Specialist | 840 Passover Rd, Osage Beach, MO 65065-2834 | 2017-05-12 |
| City | SAINT PETERS |
| Zip Code | 63376 |
Please comment or provide details below to improve the information on MS. ELIZABETH MULLANPHY JUDD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.