Provider Demographics
NPI:1528253002
Name:MORGAN, JUDDY (CRNP)
Entity type:Individual
Prefix:
First Name:JUDDY
Middle Name:
Last Name:MORGAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JUDDY
Other - Middle Name:
Other - Last Name:BUREY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:451 N HUNGERFORD DR. STE 119 RM 114
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5664
Mailing Address - Country:US
Mailing Address - Phone:443-978-1330
Mailing Address - Fax:
Practice Address - Street 1:9037 SHADY GROVE CT
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1301
Practice Address - Country:US
Practice Address - Phone:443-978-1330
Practice Address - Fax:240-306-9325
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-07
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9241682163W00000X
FLARNP 9241682363LF0000X
MDCRNP205805363LF0000X
MDR205805363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD600086000Medicaid