Individual
MRS. JUDY LYNN FAJARDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGCANP-BC
Contact information
Practice address
902 N 7TH ST, CORDELE, GA 31015-3234
(229) 276-3100
Mailing address
902 N 7TH ST, CORDELE, GA 31015-3234
(229) 276-3100
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN239574
GA
363LA2200X
Adult Health Nurse Practitioner
RN239574
GA
363LG0600X
Gerontology Nurse Practitioner
RN239574
GA
Other
Enumeration date
09/24/2019
Last updated
04/13/2023
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