Provider Demographics
NPI:1033429261
Name:STAMBAUGH, JUDITH ANNE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:ANNE
Last Name:STAMBAUGH
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 1:110 BAUGHMANS LN STE 206
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4059
Mailing Address - Country:US
Mailing Address - Phone:240-439-1251
Mailing Address - Fax:307-459-6733
Practice Address - Street 1:110 BAUGHMANS LN STE 206
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4059
Practice Address - Country:US
Practice Address - Phone:240-439-1251
Practice Address - Fax:307-459-6733
Is Sole Proprietor?:No
Enumeration Date:2010-10-21
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC003624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD430023800Medicaid