Provider Demographics
NPI:1295979078
Name:THURMAN, SURINIA STOCKS (IBCLC, LMBT)
Entity type:Individual
Prefix:
First Name:SURINIA
Middle Name:STOCKS
Last Name:THURMAN
Suffix:
Gender:F
Credentials:IBCLC, LMBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:522 POTTS ST
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-8406
Mailing Address - Country:US
Mailing Address - Phone:704-997-9406
Mailing Address - Fax:704-896-4907
Practice Address - Street 1:522 POTTS ST
Practice Address - Street 2:
Practice Address - City:DAVIDSON
Practice Address - State:NC
Practice Address - Zip Code:28036-8406
Practice Address - Country:US
Practice Address - Phone:704-997-9406
Practice Address - Fax:704-896-4907
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2022-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20159OtherLMBT
NCL-307326OtherIBCLC