Provider Demographics
NPI:1356025043
Name:STURDIVANT, RASHONDA LAKEISHA (RN)
Entity type:Individual
Prefix:MS
First Name:RASHONDA
Middle Name:LAKEISHA
Last Name:STURDIVANT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:WINGATE
Mailing Address - State:NC
Mailing Address - Zip Code:28174-9500
Mailing Address - Country:US
Mailing Address - Phone:980-989-9327
Mailing Address - Fax:
Practice Address - Street 1:109 W ELM ST
Practice Address - Street 2:
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174-9500
Practice Address - Country:US
Practice Address - Phone:980-819-0286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC297456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse