Provider Demographics
NPI:1154859858
Name:STURDIVANT, ARNETTA MURPHY (LMBT)
Entity Type:Individual
Prefix:
First Name:ARNETTA
Middle Name:MURPHY
Last Name:STURDIVANT
Suffix:
Gender:F
Credentials:LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 RAEFORD RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3074
Mailing Address - Country:US
Mailing Address - Phone:910-307-7320
Mailing Address - Fax:
Practice Address - Street 1:5330 RAEFORD RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3074
Practice Address - Country:US
Practice Address - Phone:910-307-7320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12235225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC12235OtherNC LICENSED MASSAGE AND BODYWORK THERAPIST