Provider Demographics
NPI:1164817011
Name:BANE, SHERYL (CD(DONA))
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:BANE
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3456 S COULTER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LA PORTE
Mailing Address - State:IN
Mailing Address - Zip Code:46350-7659
Mailing Address - Country:US
Mailing Address - Phone:219-477-9550
Mailing Address - Fax:
Practice Address - Street 1:3456 S COULTER CREEK DR
Practice Address - Street 2:
Practice Address - City:LA PORTE
Practice Address - State:IN
Practice Address - Zip Code:46350-7659
Practice Address - Country:US
Practice Address - Phone:219-477-9550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula