Healthcare Provider Details

I. General information

NPI: 1639328222
Provider Name (Legal Business Name): SHERRY LYNN STEWART APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 E HEISLEY RD
MENTOR OH
44060
US

IV. Provider business mailing address

575 HILL COUNTRY DR
KERRVILLE TX
78028-6024
US

V. Phone/Fax

Practice location:
  • Phone: 440-392-9550
  • Fax: 440-392-9550
Mailing address:
  • Phone: 830-258-7762
  • Fax: 830-258-7098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP10227
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: