Provider Demographics
NPI:1790032142
Name:THREET, SHERRIE ANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:SHERRIE
Middle Name:ANN
Last Name:THREET
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 1:30630 DROUILLARD RD
Mailing Address - Street 2:LOT #10
Mailing Address - City:WALBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43465-1032
Mailing Address - Country:US
Mailing Address - Phone:419-297-6704
Mailing Address - Fax:
Practice Address - Street 1:30630 DROUILLARD RD
Practice Address - Street 2:LOT #10
Practice Address - City:WALBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43465-1032
Practice Address - Country:US
Practice Address - Phone:419-297-6704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-04
Last Update Date:2012-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN104102164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse