Provider Demographics
NPI:1326365719
Name:KETCHUM, LINDA SHERILYN (SHERI) (MSN RN)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:SHERILYN (SHERI)
Last Name:KETCHUM
Suffix:
Gender:F
Credentials:MSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4917 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7718
Mailing Address - Country:US
Mailing Address - Phone:214-590-4968
Mailing Address - Fax:214-590-1672
Practice Address - Street 1:4917 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7718
Practice Address - Country:US
Practice Address - Phone:214-590-4968
Practice Address - Fax:214-590-1672
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223698163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management