Healthcare Provider Details

I. General information

NPI: 1225646623
Provider Name (Legal Business Name): SHEROME TIARA ROSS MSN, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6000 FREEDOM SQUARE DR FL 5
INDEPENDENCE OH
44131-2577
US

IV. Provider business mailing address

6000 FREEDOM SQUARE DR FL 5
INDEPENDENCE OH
44131-2577
US

V. Phone/Fax

Practice location:
  • Phone: 866-686-2504
  • Fax:
Mailing address:
  • Phone: 866-686-2504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0027370
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0027370
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0027370
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: