Provider Demographics
NPI:1073822334
Name:STURGILL, DIANE H (PA-C)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:H
Last Name:STURGILL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:DIANE
Other - Middle Name:M
Other - Last Name:HUTCHINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3745 HOLLAND RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-2847
Mailing Address - Country:US
Mailing Address - Phone:757-962-8720
Mailing Address - Fax:757-507-9004
Practice Address - Street 1:3745 HOLLAND RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-2847
Practice Address - Country:US
Practice Address - Phone:757-962-8720
Practice Address - Fax:757-507-9004
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003351363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical