Provider Demographics
NPI:1184038192
Name:MCCURDY, SANDRA JANE (LM CPM)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:JANE
Last Name:MCCURDY
Suffix:
Gender:F
Credentials:LM CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5458 OKEMOS RD
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2925
Mailing Address - Country:US
Mailing Address - Phone:517-488-5193
Mailing Address - Fax:
Practice Address - Street 1:5458 OKEMOS RD
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2925
Practice Address - Country:US
Practice Address - Phone:517-488-5193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-17
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7601000025176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife