Provider Demographics
NPI:1508519463
Name:COLLIE, SHERID (LPN)
Entity Type:Individual
Prefix:
First Name:SHERID
Middle Name:
Last Name:COLLIE
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 1:105 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-2707
Mailing Address - Country:US
Mailing Address - Phone:302-536-1952
Mailing Address - Fax:302-536-7746
Practice Address - Street 1:105 N FRONT ST
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-2707
Practice Address - Country:US
Practice Address - Phone:302-536-1952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL2-0008599164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse