JUDITH STEWART WACKENHUT (NPI# 1275076101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275076101 |
Entity Type | Individual |
Full Name | JUDITH STEWART WACKENHUT |
Credential | CPNP |
Practice Address |
545 Triadelphia Way Alexandria VA 22312-3496 |
Practice Telephone | 2054378870 |
Practice Fax Number | 2054378875 |
Mailing Telephone | 2054378870 |
Mailing Fax Number | 2054378875 |
Enumeration Date | 2016-11-26 |
Last Update Date | 2016-11-26 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0200X |
Nurse Practitioner Specialization: Pediatrics |
0024087869 | VA | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
545 TRIADELPHIA WAY |
City | ALEXANDRIA |
State | VA |
Zip Code | 22312-3496 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639710429 | Lake Barcroft Dental Group, PC | Dentist | 6464 A1 Lincolnia Rd, Alexandria, VA 22312 | 2019-10-02 |
1538684790 | Feras Ibrahim Hawari | Internal Medicine | 4714 Minor Cir, Alexandria, VA 22312 | 2017-08-09 |
1285081984 | Nicole Heidbreder Lehr | Behavioral Analyst | 5400 Shawnee Rd Ste 208, Alexandria, VA 22312 | 2016-05-23 |
1922486372 | Fassity Home Care LLC | Home Health | 6601 Little River Turn Pike, Suit 210, Alexandria, VA 22312 | 2015-05-18 |
1730582107 | Prospect Homecare Agency | Home Health | 5568 General Washington Drive, Suite A 203, Alexandria, VA 22312 | 2014-09-30 |
1396926952 | Fairfax Home Health Care, Inc. | Home Health | 4810 Beauregard Street, Suite G4, Alexandria, VA 22312 | 2007-11-23 |
1114047768 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 5590 General Washington Drive, Alexandria, VA 22312 | 2007-03-29 |
1548339682 | Virginia Pathology Svcs PC | Pathology | 6121 Lincolnia Rd, Suite 108, Alexandria, VA 22312 | 2006-11-06 |
1336150531 | Joel Carlton Goldstein | Dentist | 4605 B Pinecrest Office Park Dr, Alexandria, VA 22312 | 2006-08-11 |
1619915923 | Jong K Lee | Family Medicine | 4605 A Pinecrest Office, Alexandria, VA 22312 | 2006-06-02 |
Find all providers in zip 22312 |
Taxonomy Code | 363LP0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Pediatrics |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669097978 | Madison Smith | Nurse Practitioner | 1220 Wythe St Apt 258, Alexandria, VA 22314-2279 | 2020-06-11 |
1013542349 | Juliet Brown | Nurse Practitioner | 5249 Duke St Ste 303, Alexandria, VA 22304-2907 | 2020-03-06 |
1033679501 | Laura Elizabeth Williamson | Nurse Practitioner | 501 Medical Center Dr Ste 100, Alexandria, LA 71301-8124 | 2019-03-21 |
1811304629 | Chasity D Amy | Nurse Practitioner | 6318 Bayou Crossing Dr, Alexandria, LA 71303-7028 | 2014-07-14 |
1366408817 | Paula A Manion | Nurse Practitioner | 6303 Little River Tpke, # 300, Alexandria, VA 22312 | 2006-04-25 |
1801852355 | Theresa P Tangherlini | Nurse Practitioner | 6303 Little River Tpke #300, Alexandria, VA 22312 | 2006-04-25 |
1548252760 | Linda M Paul | Nurse Practitioner | 3330 Masonic Dr, Alexandria, LA 71301-3841 | 2005-08-16 |
1669474797 | Carolyn Sue Lemoine | Nurse Practitioner | St. Frances Cabrini Hospital School Based Centers, 3330 Masonic Dr., Alexandria, LA 71301 | 2005-06-01 |
1083225940 | Ranassa Renee Smith | Nurse Practitioner | 2226 Worley Dr, Alexandria, LA 71301-3600 | 2020-08-13 |
1881202505 | Tisha Linn Walter | Nurse Practitioner | 7015c Manchester Blvd, Alexandria, VA 22310-3420 | 2020-07-20 |
Find all providers in ALEXANDRIA |
City | ALEXANDRIA |
Zip Code | 22312 |
Please comment or provide details below to improve the information on JUDITH STEWART WACKENHUT.
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.