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DOMINIQUE ELYCIA STURDIVANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
801 OSTRUM ST, BETHLEHEM, PA 18015-1000
(484) 426-8000
Mailing address
PO BOX 5520, BETHLEHEM, PA 18015-0520

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
RN660911
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN660911
PA

Other

Enumeration date
06/28/2022
Last updated
11/25/2022
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