Provider Demographics
NPI:1396016572
Name:KAISER, SHERRY (LPN)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:KAISER
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 1:3430 JESSUP RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6273
Mailing Address - Country:US
Mailing Address - Phone:513-237-2187
Mailing Address - Fax:
Practice Address - Street 1:3430 JESSUP RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6273
Practice Address - Country:US
Practice Address - Phone:513-237-2187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH132973-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse