Provider Demographics
NPI:1780810747
Name:STURGILL, DIANA LYNN (LPN)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:STURGILL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 MISTY MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:PORT DEPOSIT
Mailing Address - State:MD
Mailing Address - Zip Code:21904-2300
Mailing Address - Country:US
Mailing Address - Phone:443-206-8305
Mailing Address - Fax:
Practice Address - Street 1:50 MISTY MEADOW DR
Practice Address - Street 2:
Practice Address - City:PORT DEPOSIT
Practice Address - State:MD
Practice Address - Zip Code:21904-2300
Practice Address - Country:US
Practice Address - Phone:443-206-8305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP25700164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse