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TIA LA'SHEY STURDIVANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
1725 PINE ST, MONTGOMERY, AL 36106-1117
(334) 293-8000
Mailing address
403 COUNTY ROAD 819, SELMA, AL 36701-1901

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-149855
AL

Other

Enumeration date
11/11/2024
Last updated
11/11/2024
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