Provider Demographics
NPI:1013904630
Name:MARSHALL, SHERI LYNETTE (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:LYNETTE
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3829 FREDERICK AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3020
Mailing Address - Country:US
Mailing Address - Phone:816-279-1668
Mailing Address - Fax:816-279-6425
Practice Address - Street 1:3829 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3020
Practice Address - Country:US
Practice Address - Phone:816-279-1668
Practice Address - Fax:816-279-6425
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO044211183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist