Healthcare Provider Details

I. General information

NPI: 1215111471
Provider Name (Legal Business Name): SYLVIA REGINA JUDD N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/24/2007
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 EAST ST
HARRINGTON DE
19952
US

IV. Provider business mailing address

PO BOX 956
FELTON DE
19943-0956
US

V. Phone/Fax

Practice location:
  • Phone: 833-886-2277
  • Fax:
Mailing address:
  • Phone: 302-399-6842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberLB0000203
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: