Provider Demographics
NPI:1336850882
Name:ROSE, SHERRI (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:ROSE
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 ROUTE 9 STE A
Mailing Address - Street 2:
Mailing Address - City:HALFMOON
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3111
Mailing Address - Country:US
Mailing Address - Phone:518-900-1115
Mailing Address - Fax:
Practice Address - Street 1:1714 ROUTE 9 STE A
Practice Address - Street 2:
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-3111
Practice Address - Country:US
Practice Address - Phone:518-900-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach