Provider Demographics
NPI:1578297982
Name:LANKFORD, JUDITH ANNE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANNE
Last Name:LANKFORD
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6873 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:DE
Mailing Address - Zip Code:19956-4211
Mailing Address - Country:US
Mailing Address - Phone:302-841-2212
Mailing Address - Fax:
Practice Address - Street 1:18119 SUSSEX HWY
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:DE
Practice Address - Zip Code:19933-4095
Practice Address - Country:US
Practice Address - Phone:302-956-6986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0012030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily