Provider Demographics
NPI:1336197383
Name:CHUKWUDI, SHERRY VALESIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:VALESIA
Last Name:CHUKWUDI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4090 DENNING SPRING DR
Mailing Address - Street 2:
Mailing Address - City:FORT IRWIN
Mailing Address - State:CA
Mailing Address - Zip Code:92310-2015
Mailing Address - Country:US
Mailing Address - Phone:760-386-4959
Mailing Address - Fax:
Practice Address - Street 1:4090 DENNING SPRING DR
Practice Address - Street 2:APT A
Practice Address - City:FORT IRWIN
Practice Address - State:CA
Practice Address - Zip Code:92310-2015
Practice Address - Country:US
Practice Address - Phone:760-386-4959
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR29558163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn