Individual
GARY T. STURTEVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-1078
(417) 347-1079
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-3649
(417) 347-9106
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
139645
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2011004383
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429043912
—
MO
Enumeration date
02/16/2007
Last updated
07/21/2022
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