Provider Demographics
NPI:1023567955
Name:STURGEON, EMILY A (LAC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:A
Last Name:STURGEON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 CUMBERLAND VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37015-2313
Mailing Address - Country:US
Mailing Address - Phone:920-222-9658
Mailing Address - Fax:
Practice Address - Street 1:210 25TH AVE N STE 521
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1606
Practice Address - Country:US
Practice Address - Phone:920-222-9658
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI905-55171100000X
KYAC115171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist