Provider Demographics
NPI:1679932461
Name:BRASS, SHERRY MARIE (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:MARIE
Last Name:BRASS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 HAYLEES WAY
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-7719
Mailing Address - Country:US
Mailing Address - Phone:541-840-3827
Mailing Address - Fax:
Practice Address - Street 1:324 HAYLEES WAY
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-7719
Practice Address - Country:US
Practice Address - Phone:541-840-3827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-22
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR098007087RN163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health