JUDITH STEWART WACKENHUT


Address: 545 Triadelphia Way, Alexandria, VA 22312-3496
Phone: 2054378870

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
0024087869 VA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 545 TRIADELPHIA WAY
City ALEXANDRIA
State VA
Zip Code 22312-3496

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1730582107 Prospect Homecare Agency Home Health 5568 General Washington Drive, Suite A 203, Alexandria, VA 22312 2014-09-30
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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City ALEXANDRIA
Zip Code 22312

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Dataset Information

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.

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