Provider Demographics
NPI:1891341194
Name:STURDEVANT, LASHUNDA MONIQUE
Entity Type:Individual
Prefix:
First Name:LASHUNDA
Middle Name:MONIQUE
Last Name:STURDEVANT
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 1:637 WINTHROP ST
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43620-1145
Mailing Address - Country:US
Mailing Address - Phone:419-470-9412
Mailing Address - Fax:
Practice Address - Street 1:637 WINTHROP ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43620-1145
Practice Address - Country:US
Practice Address - Phone:419-470-9412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health