Basic Information
Provider Information
NPI: 1275116279
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STURGILL
FirstName: DANIELLE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2000 HEALTH PARK DR FL HP2
Address2:  
City: BRENTWOOD
State: TN
PostalCode: 370274692
CountryCode: US
TelephoneNumber: 6153737600
FaxNumber: 8663461426
Practice Location
Address1: 6 HICKOK ST
Address2:  
City: CHRISTIANSBURG
State: VA
PostalCode: 240733524
CountryCode: US
TelephoneNumber: 5403826148
FaxNumber: 5403824191
Other Information
ProviderEnumerationDate: 04/28/2021
LastUpdateDate: 10/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X0024180387VAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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