Provider Demographics
NPI:1154155075
Name:STURGIS, SHEVAWN RYANN
Entity type:Individual
Prefix:
First Name:SHEVAWN
Middle Name:RYANN
Last Name:STURGIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4553 N LOOP 1604 W
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-1363
Mailing Address - Country:US
Mailing Address - Phone:210-972-8058
Mailing Address - Fax:210-899-1613
Practice Address - Street 1:4553 N LOOP 1604 W STE 1119
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1364
Practice Address - Country:US
Practice Address - Phone:210-899-1613
Practice Address - Fax:210-899-1613
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX979649163WH1000X
TX1193798363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WH1000XNursing Service ProvidersRegistered NurseHospice