Healthcare Provider Details

I. General information

NPI: 1982271359
Provider Name (Legal Business Name): STEPHANIE LOVE SOVA-LEWIS NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2021
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 ARCH ST STE 165
AKRON OH
44304-1488
US

IV. Provider business mailing address

95 ARCH ST STE 165
AKRON OH
44304-1488
US

V. Phone/Fax

Practice location:
  • Phone: 330-374-1255
  • Fax:
Mailing address:
  • Phone: 330-374-1255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0028579
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: