Provider Demographics
NPI:1427516467
Name:MARBURGER, JUDY ANN (LPN)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:MARBURGER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:ANN
Other - Last Name:HERB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:2762 CENTURY BLVD
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-3345
Mailing Address - Country:US
Mailing Address - Phone:484-220-2572
Mailing Address - Fax:484-220-2577
Practice Address - Street 1:2762 CENTURY BLVD
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-3345
Practice Address - Country:US
Practice Address - Phone:484-220-2572
Practice Address - Fax:484-220-2577
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN042671L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse