Provider Demographics
NPI:1073181475
Name:MAYER, SHERRIE R (RN)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:R
Last Name:MAYER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 AUBURN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-5686
Mailing Address - Country:US
Mailing Address - Phone:502-889-9897
Mailing Address - Fax:
Practice Address - Street 1:2200 STONY BROOK DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-4014
Practice Address - Country:US
Practice Address - Phone:502-491-4692
Practice Address - Fax:502-491-4693
Is Sole Proprietor?:No
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY1110586364SL0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SL0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistLong-Term Care