Healthcare Provider Details

I. General information

NPI: 1750312500
Provider Name (Legal Business Name): TARA LYNN STURGIS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 W STATE ST
DOYLESTOWN PA
18901-2554
US

IV. Provider business mailing address

PO BOX 829641
PHILADELPHIA PA
19182-9641
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-2885
  • Fax: 215-345-2552
Mailing address:
  • Phone: 267-370-5295
  • Fax: 215-230-3725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License NumberSP008808
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNJ00103000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: