Provider Demographics
NPI:1164473500
Name:KONTOS, SHERRY REED (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:REED
Last Name:KONTOS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DEXTER CT
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-3461
Mailing Address - Country:US
Mailing Address - Phone:563-344-6746
Mailing Address - Fax:563-344-6740
Practice Address - Street 1:3400 DEXTER CT
Practice Address - Street 2:SUITE 101
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3461
Practice Address - Country:US
Practice Address - Phone:563-344-6746
Practice Address - Fax:563-344-6740
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 10531163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3632017Medicaid
TN3632017Medicare ID - Type Unspecified