Provider Demographics
NPI:1699025932
Name:WHALEY, SHERRY LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LYNN
Last Name:WHALEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 BASKET RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9609
Mailing Address - Country:US
Mailing Address - Phone:595-259-1619
Mailing Address - Fax:
Practice Address - Street 1:350 BASKET RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-9609
Practice Address - Country:US
Practice Address - Phone:585-259-1619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY296797-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse