Provider Demographics
NPI:1114352697
Name:LEE, SHERRY (LPN)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 THOMAS CAIRO BLVD
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-6981
Mailing Address - Country:US
Mailing Address - Phone:843-375-4646
Mailing Address - Fax:843-745-2182
Practice Address - Street 1:3300 THOMAS CAIRO BLVD
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-6981
Practice Address - Country:US
Practice Address - Phone:843-375-4646
Practice Address - Fax:843-745-2182
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPR44775163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool