Provider Demographics
NPI:1396769766
Name:AMENT-STURTEVANT, SHERRIE J (FNP)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:J
Last Name:AMENT-STURTEVANT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:SHERRIE
Other - Middle Name:J
Other - Last Name:AMENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 802843
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64180-2843
Mailing Address - Country:US
Mailing Address - Phone:417-730-6430
Mailing Address - Fax:417-269-7567
Practice Address - Street 1:3203 E OLD STONE AVE
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MO
Practice Address - Zip Code:65619-9620
Practice Address - Country:US
Practice Address - Phone:417-269-1910
Practice Address - Fax:417-269-1916
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO140271363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO429115710Medicaid
MO429115710Medicaid
MO500410010Medicare PIN