Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 71008358A | IN |
N | 207RH0002X | Hospice and Palliative Medicine | 71008358A | IN |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 71008358A | IN |
NPI | 1215412028 |
---|---|
Provider Name | Ms. Kourtney Adon Sterling |
First Address | Detroit, MI 48278-1076 |
Second Address | Indianapolis, IN 46237-8601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2018 |
Last Update Date | 07/10/2021 |