Provider Demographics
NPI:1497821177
Name:O'CONNOR, SHERRILYN LYNETTE (RNFA)
Entity Type:Individual
Prefix:
First Name:SHERRILYN
Middle Name:LYNETTE
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13430
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85732-3430
Mailing Address - Country:US
Mailing Address - Phone:520-888-2244
Mailing Address - Fax:520-318-1045
Practice Address - Street 1:4188 E STONE RIVER DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6651
Practice Address - Country:US
Practice Address - Phone:520-888-2244
Practice Address - Fax:520-318-1045
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN038904163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z6596OtherHEALTHNET PROVIDER #
AZAZ0401360OtherBCBS PROVIDER #