CHRISTIAN MICHAEL JUDD (NPI# 1700121332) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700121332 |
| Entity Type | Individual |
| Full Name | CHRISTIAN MICHAEL JUDD |
| Credential | RN |
| Practice Address |
4460 S Highland Dr Ste 210 Salt Lake City UT 84124 |
| Mailing Address |
4460 S Highland Dr Ste 210 Salt Lake City UT 84124-3550 |
| Practice Telephone | 8889494864 |
| Mailing Telephone | 8889494864 |
| Enumeration Date | 2012-12-08 |
| Last Update Date | 2019-09-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP0809X |
Registered Nurse Specialization: Psych/Mental Health, Adult |
5254477-3102 | UT | Nursing Service Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 750 N Freedom Blvd, Provo, UT 846011677 | 8013734760 | 8013730639 |
| Street Address |
4460 S HIGHLAND DR STE 210 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912077629 | Charmaine Regina Stapfer | Counselor | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124 | 2006-11-09 |
| 1679174908 | Theresa Furbish | Nurse Practitioner | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1841891173 | Anastasia Holmen | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1740881077 | Marianne Longoria | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1700487048 | Michelle Teresa Wilcock | Pharmacy Technician | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1730780065 | Wilson Lee | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-11-03 |
| 1952901837 | Brenda Sariah Lopez | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-10-29 |
| 1437759669 | Ian Grant White | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-10-27 |
| 1528668035 | Carina Terry | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-10-26 |
| 1114526282 | Alishka Khaosanga | Case Manager/Care Coordinator | 4460 S Highland Dr Ste 210, Salt Lake City, UT 84124-3550 | 2020-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487273298 | Shannon Penny Price | Social Worker | 4465 Maybeck Place, Condo C, Millcreek, UT 84124 | 2020-04-11 |
| 1922654367 | Joseph C Melvin Md PC | Colon & Rectal Surgery | 1250 East 3900 South Ste 320, Salt Lake City, UT 84124 | 2019-08-12 |
| 1366923252 | Melanie Stumpf | Counselor | 1141 E 3900, Suite A170, Salt Lake City, UT 84124 | 2018-08-28 |
| 1376033993 | Michelle Flowers | Speech-Language Pathologist | 2120 East 3900 South, Ste 200, Holladay, UT 84124 | 2018-05-18 |
| 1740797257 | Lissa Anne Hutchings | Nurse Practitioner | 1160 E 3900 S Ste 4100, Salt Lake City, UT 84124 | 2018-01-05 |
| 1316465693 | Randy Gines | Counselor | 4460 S Highland Drive # 230, Murray, UT 84124 | 2017-09-06 |
| 1417470717 | Joshua Chandler Spencer | Counselor | 4460 South Highland Dr., 230, Murray, UT 84124 | 2017-07-19 |
| 1659891554 | Marcus Whitney | Counselor | 4460 S Highland Dr. # 230, Murray, UT 84124 | 2017-06-21 |
| 1518496884 | Courtney Nilson | Counselor | 4460 S. Highland Dr. #230, Murray, UT 84124 | 2017-06-08 |
| 1841687126 | Intrafilrx | Preferred Provider Organization | 3920 S 1100 E Ste 210, Salt Lake City, UT 84124 | 2015-04-23 |
| Find all providers in zip 84124 | ||||
| Taxonomy Code | 163WP0809X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Psych/Mental Health, Adult |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124048319 | Stella Blight | Registered Nurse | 500 S. Foothill Blvd, George Wahlen Vamc, Salt Lake City, UT 84109 | 2006-07-20 |
| 1629003900 | Helen L Stanhope | Registered Nurse | 1399 South 700 Easrt, Suite 17b, Salt Lake City, UT 84105 | 2006-07-12 |
| 1790727733 | Lisa Ann Jensen | Registered Nurse | Slc Va Health Care System, 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2006-06-12 |
| 1619955812 | John Richard Mitchell | Registered Nurse | 5965 South 900 East, Ste 240 Valley Mental Health Ad, Salt Lake City, UT 84121-1720 | 2006-01-06 |
| 1568449619 | Sue Ellen Fisher | Registered Nurse | 2994 Tolcate Ln, Salt Lake City, UT 84121-1529 | 2005-12-29 |
| 1497745301 | Debra Lynn Falvo | Registered Nurse | 5965 S 900 E, Salt Lake City, UT 84121-1720 | 2005-10-24 |
| 1043835630 | Cynthia Garbett | Registered Nurse | 265 E 100 S Ste 250, Salt Lake City, UT 84111-1643 | 2020-06-10 |
| 1538350749 | Samuel B Vincent | Registered Nurse | 404 S 400 W, Salt Lake City, UT 84101-2201 | 2007-08-05 |
| 1700908159 | Rebecca Clough | Registered Nurse | 500 Foothill Blvd, Salt Lake City, UT 84148-0001 | 2007-04-05 |
| 1164490520 | Theresa J. Mccormick | Registered Nurse | 1399 S 700 E, Suite F-14, Salt Lake City, UT 84105-2149 | 2006-03-10 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84124 |
Please comment or provide details below to improve the information on CHRISTIAN MICHAEL JUDD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.