Southern, Judy
Southern, Judy is an sole proprietor health care provider with primary practice located at 1100 E Wendover Ave , Greensboro NC 27405-6713. She recently has only one registered license in Nursing Service Providers / Administrator, which is considered as her primary health care specialty. Southern, Judy can be contacted via phone (336) 641-3712.Contact Information
Primary practice address
1100 E Wendover Ave
Greensboro NC 27405-6713
Phone: (336) 641-3712
Fax: (336) 641-6603
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Administrator | 163WA2000X | 59604 | North Carolina |
Profile Details
| NPI number | 1003118092 |
|---|---|
| LBN Legal business name | Southern, Judy |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 23rd, 2010 |
| Last updated | Nov 23rd, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003118092 | NPPES |
| North Carolina | MEDICAID | 1245272657 |
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