Individual
JUDY SASSER STANFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4600 CUMBERLAND RD, FAYETTEVILLE, NC 28306-2412
(910) 429-1690
Mailing address
3803 N ELM ST, GREENSBORO, NC 27455-2593
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
600110
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500024589
RR MEDICARE
—
05
—
7000914
—
NC
01
—
7370730
AETNA
—
01
—
B3900
MEDCOST
—
Enumeration date
12/13/2005
Last updated
07/23/2014
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