Healthcare Provider Details

I. General information

NPI: 1134314339
Provider Name (Legal Business Name): MRS. SHERI LYNN STOWERS-WATTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 09/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5620 NW 28TH TER
GAINESVILLE FL
32653-1873
US

IV. Provider business mailing address

5620 NW 28TH TER
GAINESVILLE FL
32653-1873
US

V. Phone/Fax

Practice location:
  • Phone: 352-871-3129
  • Fax:
Mailing address:
  • Phone: 352-871-3129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberCNA113651
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: