Provider Demographics
NPI:1629008800
Name:RHOADS, SHERRIE L (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:L
Last Name:RHOADS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 RAINCREEK TRL NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35811-2611
Mailing Address - Country:US
Mailing Address - Phone:256-533-4626
Mailing Address - Fax:256-533-4710
Practice Address - Street 1:2325 PANSY ST SW
Practice Address - Street 2:SUITE E
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3834
Practice Address - Country:US
Practice Address - Phone:256-533-4626
Practice Address - Fax:256-533-4710
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAL 1 076214363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA891005660Medicaid
LAP96910Medicare UPIN
AL051554113RHOMedicare ID - Type Unspecified