MEDICARE: SHERRY MORRIS STOUGH CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LN0000X	Neonatal Nurse Practitioner	1-033297	AL

General Provider Information

NPI Number	:	1891931192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY MORRIS STOUGH CRNP

Provider Business Mailing Address
First Line	:	1608 GREAT PINE RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-2819
Country	:	US
Telephone Number	:	205-854-2772
Fax Number	:	205-854-8528

Provider Business Practice Location Address
First Line	:	1608 GREAT PINE RD
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35235-2819
Country	:	US
Telephone Number	:	205-854-2772
Fax Number	:	205-854-8528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2008
Last Update Date	:	12/17/2008

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