Provider Demographics
NPI:1235155474
Name:LULF, SHERRY LEE (RN)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LEE
Last Name:LULF
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:RELIANCE
Mailing Address - State:SD
Mailing Address - Zip Code:57569-2012
Mailing Address - Country:US
Mailing Address - Phone:605-473-0221
Mailing Address - Fax:605-245-2384
Practice Address - Street 1:HWY 34 & 47
Practice Address - Street 2:
Practice Address - City:FORT THOMPSON
Practice Address - State:SD
Practice Address - Zip Code:57339-0200
Practice Address - Country:US
Practice Address - Phone:605-245-1502
Practice Address - Fax:605-245-2384
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR026808163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SDR026808OtherRN LICENSE