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Individual

MRS. JUDY MARIE NIELL

Active
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Individual

MRS. JUDY MARIE NIELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02129
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207269603
TX
05
207269604
TX
05
207269605
TX
05
207269606
TX
01
75-0818167-015
TRICARE
TX
01
75-0818167-044
TRICARE
TX
01
75-0818167-048
TRICARE
TX
01
75-1976930-005
TRICARE
TX
01
75-2616977-001
TRICARE
TX
01
75-2616977-002
TRICARE
TX
01
75-2616977-022
TRICARE
TX
01
75-2616977-028
TRICARE
TX
01
8284ND
BCBS
TX
01
8287ND
BCBS
TX
01
8660NN
BCBS
TX
01
8691NN
BCBS
TX
01
P01291627
RAIL ROAD MEDICARE
TX
01
P01464137
RAIL ROAD MEDICARE
TX
Enumeration date
03/06/2007
Last updated
04/01/2016
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