Provider Demographics
NPI:1861176992
Name:CALE, JUDITH FAY
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:FAY
Last Name:CALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 MID ATLANTIC DR
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4298
Mailing Address - Country:US
Mailing Address - Phone:304-296-9898
Mailing Address - Fax:304-292-5210
Practice Address - Street 1:5007 MID ATLANTIC DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-4298
Practice Address - Country:US
Practice Address - Phone:304-296-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16468164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse