| NPI | 1831485770 |
|---|---|
| Former Name | JUDEANA ANN FOGLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: WV APRN58557) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OH COA.12579-NP) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2020-05-19 |