Provider Demographics
NPI:1457446783
Name:WINN, SHERRY KAY (RPH)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:KAY
Last Name:WINN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WINONA LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46590-1638
Mailing Address - Country:US
Mailing Address - Phone:574-267-4626
Mailing Address - Fax:574-267-8028
Practice Address - Street 1:2280 PROVIDENT CT
Practice Address - Street 2:SUITE D
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46580-3284
Practice Address - Country:US
Practice Address - Phone:574-267-4900
Practice Address - Fax:574-267-8028
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26013208A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist