Provider Demographics
NPI:1043928955
Name:CARDON, SHERRY (INTERN)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:CARDON
Suffix:
Gender:F
Credentials:INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 S RIVER RD STE B105
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5704
Mailing Address - Country:US
Mailing Address - Phone:435-669-7109
Mailing Address - Fax:
Practice Address - Street 1:720 S RIVER RD STE B105
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5704
Practice Address - Country:US
Practice Address - Phone:435-669-7109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT0OtherN/A