Provider Demographics
NPI:1043867716
Name:DONOVAN, SHERRY LEE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LEE
Last Name:DONOVAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N 90TH AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-1420
Mailing Address - Country:US
Mailing Address - Phone:509-965-5220
Mailing Address - Fax:
Practice Address - Street 1:104 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-2636
Practice Address - Country:US
Practice Address - Phone:509-573-7051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00159754163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool