Provider Demographics
NPI:1922007616
Name:NUNN, SHERRIE ANTHONY (OD)
Entity Type:Individual
Prefix:DR
First Name:SHERRIE
Middle Name:ANTHONY
Last Name:NUNN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:511 CROSSING DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2628
Mailing Address - Country:US
Mailing Address - Phone:303-665-2068
Mailing Address - Fax:303-665-5473
Practice Address - Street 1:511 CROSSING DR
Practice Address - Street 2:SUITE 102
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2628
Practice Address - Country:US
Practice Address - Phone:303-665-2068
Practice Address - Fax:303-665-5473
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-15
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1367152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CF0813Medicare UPIN