Provider Demographics
NPI:1154085413
Name:STURGES, MITZI (CSFA)
Entity Type:Individual
Prefix:
First Name:MITZI
Middle Name:
Last Name:STURGES
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3459 CRUSE LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46160-8351
Mailing Address - Country:US
Mailing Address - Phone:317-626-8148
Mailing Address - Fax:
Practice Address - Street 1:3459 CRUSE LN
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:IN
Practice Address - Zip Code:46160-8351
Practice Address - Country:US
Practice Address - Phone:317-626-8148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-23
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant