Provider Demographics
NPI:1659194694
Name:STURKEY, LAVON PATRICE
Entity type:Individual
Prefix:
First Name:LAVON
Middle Name:PATRICE
Last Name:STURKEY
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 1:155 CHEROKEE PL # 1049
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30121-2966
Mailing Address - Country:US
Mailing Address - Phone:706-725-5858
Mailing Address - Fax:706-979-6468
Practice Address - Street 1:420 AUTREY DR
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30134-4826
Practice Address - Country:US
Practice Address - Phone:706-725-5858
Practice Address - Fax:706-979-6468
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health