ELLEN K JUDD P.A. NPI 1972560480

NPI Information

  • NPI: 1972560480
  • Provider Name: ELLEN K JUDD, P.A.
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1308 BENNETT AVE
    BURLEY, ID
    ZIP 83318
  • Phone: (208) 678-7796

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NPI Details

Ellen K Judd, P.A. is a medical physician assistant in Burley, ID. Ellen K Judd, P.A. NPI is 1972560480. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1308 BENNETT AVE
BURLEY, ID
ZIP 83318-665
Phone: (208) 678-7796
Fax: (208) 678-7799

The NPI 1972560480 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 4/27/2006 and was last updated on 11/26/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedicalPA-98IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1S59420MEDICARE UPINIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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