Provider Demographics
NPI:1518024009
Name:JANSSEN, SHERDEL (CNP,RN)
Entity Type:Individual
Prefix:MRS
First Name:SHERDEL
Middle Name:
Last Name:JANSSEN
Suffix:
Gender:F
Credentials:CNP,RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:IL
Mailing Address - Zip Code:62092-1002
Mailing Address - Country:US
Mailing Address - Phone:217-374-2188
Mailing Address - Fax:217-374-2189
Practice Address - Street 1:505 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:IL
Practice Address - Zip Code:62092-1002
Practice Address - Country:US
Practice Address - Phone:217-374-2188
Practice Address - Fax:217-374-2189
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner