Provider Demographics
NPI:1891397741
Name:ANDERSON, SHERYL JANE
Entity Type:Individual
Prefix:MRS
First Name:SHERYL
Middle Name:JANE
Last Name:ANDERSON
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 1:6635 LAKE OF THE WOODS PT
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9616
Mailing Address - Country:US
Mailing Address - Phone:614-570-5923
Mailing Address - Fax:
Practice Address - Street 1:6635 LAKE OF THE WOODS PT
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:OH
Practice Address - Zip Code:43021-9616
Practice Address - Country:US
Practice Address - Phone:614-570-5923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-14
Last Update Date:2020-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker