Provider Demographics
NPI:1851994487
Name:STAMBAUGH, GEORGINE DEANA
Entity Type:Individual
Prefix:
First Name:GEORGINE
Middle Name:DEANA
Last Name:STAMBAUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1806 ORA RITCHEY RD
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-2334
Mailing Address - Country:US
Mailing Address - Phone:740-532-4901
Mailing Address - Fax:
Practice Address - Street 1:253 PRIVATE DRIVE 741
Practice Address - Street 2:
Practice Address - City:KITTS HILL
Practice Address - State:OH
Practice Address - Zip Code:45645-8001
Practice Address - Country:US
Practice Address - Phone:740-547-6799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant