Provider Demographics
NPI:1376859686
Name:SHERRY BOYLEN
Entity Type:Organization
Organization Name:SHERRY BOYLEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:SHERRY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BOYLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LISCENSED NURSE
Authorized Official - Phone:606-364-3703
Mailing Address - Street 1:1272 BALDWIN BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:ANNVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40402-8657
Mailing Address - Country:US
Mailing Address - Phone:606-364-3703
Mailing Address - Fax:606-364-3703
Practice Address - Street 1:1272 BALDWIN BRANCH RD
Practice Address - Street 2:
Practice Address - City:ANNVILLE
Practice Address - State:KY
Practice Address - Zip Code:40402-8657
Practice Address - Country:US
Practice Address - Phone:606-364-3703
Practice Address - Fax:606-364-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1097620252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency