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NPI Code Detail

MEDICARE: JUDY SASSER STANFIELD NP

MEDICARE: JUDY SASSER STANFIELD NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner600110NC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2500024589OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3B3900OTHERMEDCOST
47370730OTHERAETNA

General Provider Information

NPI Number : 1013992056
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUDY SASSER STANFIELD NP
Provider Business Mailing Address
First Line : 3803 N ELM ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27455-2593
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4600 CUMBERLAND RD
Second Line :
City : FAYETTEVILLE
State : NC
Zip : 28306-2412
Country : US
Telephone Number : 910-429-1690
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 07/23/2014

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