# VISTA BLUE HEALTH AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1821856394
- **Authorized official:** MS. STEPHANY C. HASBERRY APRN (PRACTITIONER/OWNER/PARTNER)
- **Authorized official phone:** (216) 910-7450

## Contact information

- **Practice address:** 6545 MARKET AVE N STE 100, CANTON, OH 44721-2430
- **Practice address phone:** (216) 910-7450
- **Practice address fax:** (800) 324-1856
- **Mailing address:** 6545 MARKET AVE N STE 100, CANTON, OH 44721-2430
- **Mailing address phone:** (216) 910-7450
- **Mailing address fax:** (800) 324-1856

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/11/2024
- **Last updated:** 08/22/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1235747700 | — | OH |
| 05 | — | 1659983252 | — | OH |
| 05 | — | 1770905226 | — | OH |