Provider Demographics
NPI:1003990839
Name:BUSKIRK, SHERI K (RN)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:K
Last Name:BUSKIRK
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 1:515 NE GLEN OAK
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61603-3167
Mailing Address - Country:US
Mailing Address - Phone:309-674-2002
Mailing Address - Fax:309-624-9898
Practice Address - Street 1:515 NE GLEN OAK
Practice Address - Street 2:SUITE 105
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61603-3167
Practice Address - Country:US
Practice Address - Phone:309-674-2002
Practice Address - Fax:309-624-9898
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041302966163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse