Individual
MICHELLE STURDIVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
95 SUMMER LAKE CV, DALLAS, GA 30157-7617
(678) 363-5925
Mailing address
95 SUMMER LAKE CV, DALLAS, GA 30157-7617
(678) 363-5925
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
11853
GA
163WE0003X
Emergency Registered Nurse
Primary
RN163401
GA
Other
Enumeration date
07/10/2015
Last updated
07/10/2015
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