Healthcare Provider Details

I. General information

NPI: 1063969038
Provider Name (Legal Business Name): SHERRY MILLER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHERRY STEINLAGE

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 08/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 4TH ST SW
MASON CITY IA
50401-2800
US

IV. Provider business mailing address

621 S ILLINOIS AVE SUITE 103
MASON CITY IA
50401-5489
US

V. Phone/Fax

Practice location:
  • Phone: 641-428-7951
  • Fax: 641-428-7269
Mailing address:
  • Phone: 641-428-3041
  • Fax: 641-428-3059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA091469
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: