Provider Demographics
NPI:1003259151
Name:VANDYKE, SHERRI LYNN (RN)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:LYNN
Last Name:VANDYKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7357 FIRE TOWER RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:MD
Mailing Address - Zip Code:21830-1196
Mailing Address - Country:US
Mailing Address - Phone:443-521-5644
Mailing Address - Fax:
Practice Address - Street 1:3680 WARWICK RD
Practice Address - Street 2:
Practice Address - City:EAST NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21631-1420
Practice Address - Country:US
Practice Address - Phone:410-943-8108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2013-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201079163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse