Provider Demographics
NPI:1205371101
Name:OWENS, SHERRY LASHAWN (LPN)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LASHAWN
Last Name:OWENS
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 1:1929 ROBERT HALL BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23324-4328
Mailing Address - Country:US
Mailing Address - Phone:717-507-8555
Mailing Address - Fax:
Practice Address - Street 1:1929 ROBERT HALL BLVD
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23324-4328
Practice Address - Country:US
Practice Address - Phone:717-507-8555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-30
Last Update Date:2016-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA002052748164W00000X
PAPN151580L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse