Provider Demographics
NPI:1013049352
Name:STURGEON, MARTHA M (DNP ACNS-BC NP)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:M
Last Name:STURGEON
Suffix:
Gender:F
Credentials:DNP ACNS-BC NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6963 KILLARNEY DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-2190
Mailing Address - Country:US
Mailing Address - Phone:248-879-2871
Mailing Address - Fax:
Practice Address - Street 1:6963 KILLARNEY DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-2190
Practice Address - Country:US
Practice Address - Phone:248-879-2871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704110586363LA2200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse