Provider Demographics
NPI:1720665979
Name:STERLING-, TAVIE L
Entity Type:Individual
Prefix:
First Name:TAVIE
Middle Name:L
Last Name:STERLING-
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 1:4555 HIGHWAY 190
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-8137
Mailing Address - Country:US
Mailing Address - Phone:337-701-1269
Mailing Address - Fax:318-626-7179
Practice Address - Street 1:4555 HIGHWAY 190
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-8137
Practice Address - Country:US
Practice Address - Phone:337-322-9084
Practice Address - Fax:318-626-7179
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-25
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA822590849OtherNON EMERGENCY TRANSPORTION