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JUDE FOX

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1548415508

Individual Registrant:
 JUDE  FOX 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
16319 THIRD STREET  GUERNEVILLE, CA 95446 US
Tel: 707-869-5977  Fax: 707-869-5976

Contact information for business:
16319 THIRD STREET  GUERNEVILLE, CA 95446 US
Tel: 707-869-5977  Fax: 707-869-5976

Registration Information:
NPI: 1548415508
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
CAPA19987

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
1598768962CA05
BX/BS237310613CA01
1356344758CA05
MEDICARE NHICZZZ21461ZCA01
MEDICARE NHICZZZ73222ZCA01




HEALTH CARE JOBS CA - Page 1



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