Provider Demographics
NPI:1508941626
Name:WELKER, SHERRY D (WHNP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:D
Last Name:WELKER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SIKESTON
Mailing Address - State:MO
Mailing Address - Zip Code:63801-5043
Mailing Address - Country:US
Mailing Address - Phone:573-472-7535
Mailing Address - Fax:573-472-7787
Practice Address - Street 1:1013 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SIKESTON
Practice Address - State:MO
Practice Address - Zip Code:63801-5043
Practice Address - Country:US
Practice Address - Phone:573-472-7535
Practice Address - Fax:573-472-7787
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO120488363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO428634711Medicaid
P20515Medicare UPIN