Provider Demographics
NPI:1568900793
Name:SUTFIN, SHERYL (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:SUTFIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1367
Mailing Address - Street 2:
Mailing Address - City:MANILA
Mailing Address - State:AR
Mailing Address - Zip Code:72442-1367
Mailing Address - Country:US
Mailing Address - Phone:870-828-2259
Mailing Address - Fax:
Practice Address - Street 1:3501 STONEGATE DR STE F
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-7394
Practice Address - Country:US
Practice Address - Phone:870-215-0427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-08
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR053483163W00000X
MO2019044730363LF0000X
AR122195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse