Provider Demographics
NPI:1497985584
Name:ROBERTS, SHERLYN MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SHERLYN
Middle Name:MARIE
Last Name:ROBERTS
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 1:918 HARROW RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43615-4520
Mailing Address - Country:US
Mailing Address - Phone:419-810-3590
Mailing Address - Fax:
Practice Address - Street 1:918 HARROW RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-4520
Practice Address - Country:US
Practice Address - Phone:419-810-3590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN122226-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse