Healthcare Provider Details

I. General information

NPI: 1477782357
Provider Name (Legal Business Name): SHERI STONE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2009
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 BRENNAN RD
LA FAYETTE NY
13084-9548
US

IV. Provider business mailing address

2741 BRENNAN RD
LA FAYETTE NY
13084-9548
US

V. Phone/Fax

Practice location:
  • Phone: 315-391-6102
  • Fax: 757-432-3331
Mailing address:
  • Phone: 315-391-6102
  • Fax: 757-432-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number336004
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: