Individual
SHERRY LYNN STANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9858 W STATE ST, STAR, ID 83669-5210
(208) 286-9471
(208) 286-0565
Mailing address
9858 W STATE ST, STAR, ID 83669-5210
(208) 286-9471
(208) 286-0565
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0024175932
VA
363LF0000X
Family Nurse Practitioner
Primary
57869
ID
Other
Enumeration date
02/09/2018
Last updated
09/09/2020
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