Provider Demographics
NPI:1093971483
Name:SHERA, MARY BETH
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BETH
Last Name:SHERA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 INDIAN GAP RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-9447
Mailing Address - Country:US
Mailing Address - Phone:502-545-6456
Mailing Address - Fax:502-875-8673
Practice Address - Street 1:959 LEESTOWN LN
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-2005
Practice Address - Country:US
Practice Address - Phone:502-875-8666
Practice Address - Fax:502-875-8673
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator