Provider Demographics
NPI:1033397658
Name:LEARY, SHERYL E (MS RN CNS CCNS)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:E
Last Name:LEARY
Suffix:
Gender:F
Credentials:MS RN CNS CCNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 FORD RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93924-9662
Mailing Address - Country:US
Mailing Address - Phone:831-298-7007
Mailing Address - Fax:
Practice Address - Street 1:76 FORD RD
Practice Address - Street 2:
Practice Address - City:CARMEL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93924-9662
Practice Address - Country:US
Practice Address - Phone:831-298-7007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA466267163W00000X
CA2156364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist