Provider Demographics
NPI:1376664425
Name:PAGE, SHERI L (RN)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:L
Last Name:PAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SHERI
Other - Middle Name:L
Other - Last Name:BARTLETT - WARNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:80 STATE HIGHWAY 310
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CANTON
Mailing Address - State:NY
Mailing Address - Zip Code:13617-1493
Mailing Address - Country:US
Mailing Address - Phone:315-386-2189
Mailing Address - Fax:315-386-2435
Practice Address - Street 1:80 STATE HIGHWAY 310 STE 1
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617-1436
Practice Address - Country:US
Practice Address - Phone:315-386-2189
Practice Address - Fax:315-386-2435
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY561636163WA0400X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)