Provider Demographics
NPI:1053391755
Name:ARTMAN, JUDY A (APRN)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:A
Last Name:ARTMAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23822 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-3245
Mailing Address - Country:US
Mailing Address - Phone:313-359-0200
Mailing Address - Fax:313-359-0202
Practice Address - Street 1:23822 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-3245
Practice Address - Country:US
Practice Address - Phone:313-359-0200
Practice Address - Fax:313-359-0202
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704113126363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P84869Medicare UPIN