Provider Demographics
NPI:1326808148
Name:TABUDLONG, MARGARITA (FNP-C)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:TABUDLONG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8775 FOSTER CIR
Mailing Address - Street 2:
Mailing Address - City:FORT GEORGE G MEADE
Mailing Address - State:MD
Mailing Address - Zip Code:20755-1502
Mailing Address - Country:US
Mailing Address - Phone:805-844-3859
Mailing Address - Fax:
Practice Address - Street 1:2200 DEFENSE HWY STE 103
Practice Address - Street 2:
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-2458
Practice Address - Country:US
Practice Address - Phone:410-721-5280
Practice Address - Fax:410-721-2243
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-20
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR264055363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily