Provider Demographics
NPI:1861033755
Name:STURM, LISA G
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:G
Last Name:STURM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7420 LAUREN DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-7377
Mailing Address - Country:US
Mailing Address - Phone:812-484-9795
Mailing Address - Fax:
Practice Address - Street 1:7420 LAUREN DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-7377
Practice Address - Country:US
Practice Address - Phone:812-484-9795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider