Basic Information
Provider Information
NPI: 1619001773
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STURTEVANT
FirstName: JANET
MiddleName: E.
NamePrefix:  
NameSuffix:  
Credential: M.ED.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 500 RAY C HUNT DR
Address2:  
City: CHARLOTTESVILLE
State: VA
PostalCode: 229032981
CountryCode: US
TelephoneNumber: 4349806140
FaxNumber: 4349724266
Practice Location
Address1: 415 RAY C HUNT DR
Address2: UVA ENT AT FONTAINE
City: CHARLOTTESVILLE
State: VA
PostalCode: 22903
CountryCode: US
TelephoneNumber: 4349242050
FaxNumber: 4349820700
Other Information
ProviderEnumerationDate: 03/14/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X2201000350VAY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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