Provider Demographics
NPI:1427435445
Name:JUEN-STURGIS, MAGGIE (CRNA)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:JUEN-STURGIS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 COLLEGE AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-5307
Mailing Address - Country:US
Mailing Address - Phone:810-210-7467
Mailing Address - Fax:
Practice Address - Street 1:1219 S ALTA VISTA AVE
Practice Address - Street 2:APT 124
Practice Address - City:MONROVIA
Practice Address - State:CA
Practice Address - Zip Code:91016-4025
Practice Address - Country:US
Practice Address - Phone:810-210-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-28
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA841598367500000X
MI4704276048367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered