Organization Name: | STURGEON FAMILY NURSE PRACTITIONER HEALTH CARE,PLC |
NPI Number: | 1093074650 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JO ANN STURGEON (MANAGER) |
Mailing Address: | 18 Plaza South St Tahlequah |
State: | OK US |
Postal Code: | 744644751 |
Phone Number: | 9182070970 |
Fax Number: | 9182070971 |
NPI Enumeration Date: | 05/16/2012 |
NPI Last Update Date: | 06/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 49778 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |