Provider Demographics
NPI:1528357910
Name:EALEY, SHERI LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:LYNN
Last Name:EALEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 252
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-0252
Mailing Address - Country:US
Mailing Address - Phone:816-716-3555
Mailing Address - Fax:
Practice Address - Street 1:1115 E PENCE RD
Practice Address - Street 2:MEDICAL
Practice Address - City:CAMERON
Practice Address - State:MO
Practice Address - Zip Code:64429-8804
Practice Address - Country:US
Practice Address - Phone:816-716-3555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009030209163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice