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General NPI Number Information
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NPI Number | 1568543155
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Entity Type | Individual
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Provider Name | SHERI L STOFER PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 1905 W 19TH ST
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City | MOUNTAIN GROVE
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State | MO
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Zip | 65711-1287
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Country | US
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Telephone | 417-926-1770
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Fax | 417-926-1785
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Provider Business Mailing Address
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Address Line | 1905 W 19TH ST
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City | MOUNTAIN GROVE
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State | MO
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Zip | 65711-1287
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Country | US
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Telephone | 417-926-1770
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Fax | 417-926-1785
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 2003004256
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2003004256
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License Number State | MO
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