Provider Demographics
NPI:1043238058
Name:PHILBY, SHERYLL LOUISE (RN)
Entity Type:Individual
Prefix:MS
First Name:SHERYLL
Middle Name:LOUISE
Last Name:PHILBY
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 1:213 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-2521
Mailing Address - Country:US
Mailing Address - Phone:419-423-8581
Mailing Address - Fax:
Practice Address - Street 1:307 S JOHNSON ST
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:OH
Practice Address - Zip Code:45810-1425
Practice Address - Country:US
Practice Address - Phone:419-634-1670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN272726163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2653052Medicaid