Provider Demographics
NPI:1659882140
Name:TIMMONS, SHERRI L
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:L
Last Name:TIMMONS
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 1:108 RYAN ST
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:WV
Mailing Address - Zip Code:26170-4549
Mailing Address - Country:US
Mailing Address - Phone:304-299-5058
Mailing Address - Fax:
Practice Address - Street 1:108 RYAN ST
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:WV
Practice Address - Zip Code:26170-4549
Practice Address - Country:US
Practice Address - Phone:304-299-5058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant