Provider Demographics
NPI:1962023887
Name:STURGES, JOURDAN (MEDICAL STUDENT)
Entity Type:Individual
Prefix:
First Name:JOURDAN
Middle Name:
Last Name:STURGES
Suffix:
Gender:F
Credentials:MEDICAL STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 NOVATE LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6163
Mailing Address - Country:US
Mailing Address - Phone:405-657-8981
Mailing Address - Fax:
Practice Address - Street 1:1880 NOVATE LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-6163
Practice Address - Country:US
Practice Address - Phone:405-657-8981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program