Provider Demographics
NPI:1932886538
Name:STURDIVANT, MEGAN ANN (APRN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:STURDIVANT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SUNRISE LN
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-5818
Mailing Address - Country:US
Mailing Address - Phone:423-278-8765
Mailing Address - Fax:
Practice Address - Street 1:106 SUNRISE LN
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-5818
Practice Address - Country:US
Practice Address - Phone:423-278-8765
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000223357163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse