Provider Demographics
NPI:1194361055
Name:WORKMAN, JUSTINA (FNP-C)
Entity type:Individual
Prefix:
First Name:JUSTINA
Middle Name:
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:JUSTINA
Other - Middle Name:
Other - Last Name:STEVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1125 DIAMOND DR
Mailing Address - Street 2:STE B
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5857
Mailing Address - Country:US
Mailing Address - Phone:301-790-1482
Mailing Address - Fax:
Practice Address - Street 1:1125 DIAMOND DR
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5857
Practice Address - Country:US
Practice Address - Phone:301-790-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR160986363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily