Healthcare Provider Details

I. General information

NPI: 1437714698
Provider Name (Legal Business Name): SARAH DEWEESE STONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 12/11/2020
Certification Date: 12/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 23RD ST N
PELL CITY AL
35125-9310
US

IV. Provider business mailing address

201 MONROE ST STE 1300
MONTGOMERY AL
36104-3771
US

V. Phone/Fax

Practice location:
  • Phone: 205-338-3357
  • Fax:
Mailing address:
  • Phone: 334-206-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1-152081
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-152081
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: