Healthcare Provider Details

I. General information

NPI: 1649174616
Provider Name (Legal Business Name): SIERRA BETH VAN WINKLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIERRA BETH WILLIAMS

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 S MULBERRY ST STE A
MOUNT VERNON OH
43050-3331
US

IV. Provider business mailing address

206 S MULBERRY ST STE A
MOUNT VERNON OH
43050-3331
US

V. Phone/Fax

Practice location:
  • Phone: 740-326-1231
  • Fax:
Mailing address:
  • Phone: 740-326-1231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.405297
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: