VISTA BLUE HEALTH AND WELLNESS LLC NPI 1821856394

NPI Information

NPI: 1821856394
Provider Name: VISTA BLUE HEALTH AND WELLNESS LLC
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
6545 MARKET AVE N STE 100
CANTON, OH
ZIP 44721
Phone: (216) 973-2087
Get Directions

VISTA BLUE HEALTH AND WELLNESS LLC is a primary care nurse practitioner in Canton, OH. VISTA BLUE HEALTH AND WELLNESS LLC NPI is 1821856394. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6545 MARKET AVE N STE 100
CANTON, OH
ZIP 44721-430
Phone: (216) 973-2087

The provider's authorized official is Stephany C. Hasberry .
The authorized official title is Practitioner/owner/partner and has the following contact phone number (216) 910-7451.

The enumeration date for this NPI number is 3/11/2024 and was last updated on 4/2/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			No
2	363LP2300X	Nurse Practitioner	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1235747700	MEDICAID	OHIO
2	1659983252	MEDICAID	OHIO
3	1770905226	MEDICAID	OHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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