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General NPI Number Information
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NPI Number | 1487008090
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Entity Type | Organization
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Legal Business Name | KATIE STURDEVANT, P.C.
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 3600 VILLAGE DR STE 110
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City | LINCOLN
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State | NE
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Zip | 68516-6631
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Country | US
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Telephone | 402-875-9270
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Fax |
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Provider Business Mailing Address
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Address Line | 3600 VILLAGE DRIVE, STE 110
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City | LINCOLN
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State | NE
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Zip | 68516-6621
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Country | US
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Telephone | 402-875-9270
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Fax | 402-875-9272
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Authorized Official
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Title or Position | APRN-BC
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Name | KATIE STURDEVANT
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Credential | APRN-BC
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Telephone | 402-875-9270
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 111649
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License Number State | NE
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