Organization
VISTA BLUE HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STEPHANY C. HASBERRY APRN (PRACTITIONER/OWNER/PARTNER)
(216) 910-7450
Entity
Organization
Contact information
Practice address
6545 MARKET AVE N STE 100, CANTON, OH 44721-2430
(216) 910-7450
(800) 324-1856
Mailing address
6545 MARKET AVE N STE 100, CANTON, OH 44721-2430
(216) 910-7450
(800) 324-1856
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235747700
—
OH
05
—
1659983252
—
OH
05
—
1770905226
—
OH
Enumeration date
03/11/2024
Last updated
08/22/2024
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