Healthcare Provider Details

I. General information

NPI: 1235859216
Provider Name (Legal Business Name): STERLIN JOURDAIN MS, APRN, CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: STERLIN JOUDAIN

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 10/10/2022
Certification Date: 10/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14000 FIVAY RD
HUDSON FL
34667-7103
US

IV. Provider business mailing address

692 LOCKE POINTE DR NE
FRIDLEY MN
55432-3274
US

V. Phone/Fax

Practice location:
  • Phone: 727-819-2929
  • Fax:
Mailing address:
  • Phone: 561-809-4320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11022178
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: