Provider Demographics
NPI:1922503911
Name:STURGEON, BRIANNE ELIZABETH
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:ELIZABETH
Last Name:STURGEON
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 1:2511 CLAY PIKE
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-3011
Mailing Address - Country:US
Mailing Address - Phone:724-757-7968
Mailing Address - Fax:
Practice Address - Street 1:146 RECREATION BLDG
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-5700
Practice Address - Country:US
Practice Address - Phone:814-865-2725
Practice Address - Fax:814-865-7936
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer