Provider Demographics
NPI:1548001282
Name:STURM, SALLY MARY (RN)
Entity type:Individual
Prefix:
First Name:SALLY
Middle Name:MARY
Last Name:STURM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 SHADES OF DEATH RD
Mailing Address - Street 2:
Mailing Address - City:GREAT MEADOWS
Mailing Address - State:NJ
Mailing Address - Zip Code:07838-2711
Mailing Address - Country:US
Mailing Address - Phone:908-797-5419
Mailing Address - Fax:
Practice Address - Street 1:99 BEAUVOIR AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3533
Practice Address - Country:US
Practice Address - Phone:908-522-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR21025200163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine