| Doctor Name: | TINA ANN JUDGE |
| NPI Number: | 1174591606 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | MJ0925985 |
| Business Practice Address: | 9 Pinnacle Dr Suite 105 Fishersville, VA - 229392366 |
| Business Phone Number: | 5406882646 |
| Business Fax Number: | 5406882656 |
| Mailing Address: | 53 Erem Way, FISHERSVILLE |
| State: | VA |
| Postal Code: | 229392132 |
| Phone Number: | 5402567302 |
| Fax Number: | |
| NPI Enumeration Date: | 03/10/2006 |
| NPI Last Update Date: | 08/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | MJ0925985 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |