Individual
BONNIE SUE JUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
203 E COMMERCE ST, WAVERLY, TN 37185-1629
(931) 296-5833
(931) 296-7388
Mailing address
203 E COMMERCE ST, WAVERLY, TN 37185-1629
(931) 296-5833
(931) 296-7388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
6534
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36404231
—
TN
01
—
4157094
BCBS OF TN PIN
TN
Enumeration date
07/12/2006
Last updated
01/19/2009
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