Provider Demographics
NPI:1659872810
Name:ADAMS, SHERI DAWN
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:DAWN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14331 W MANDALAY LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-5780
Mailing Address - Country:US
Mailing Address - Phone:602-989-1091
Mailing Address - Fax:
Practice Address - Street 1:17032 W SURPRISE FARMS LOOP S
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-1581
Practice Address - Country:US
Practice Address - Phone:623-523-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE23318164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty