Provider Demographics
NPI:1669561015
Name:MCGINN, SHERRY A (RN)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:A
Last Name:MCGINN
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 1:1125 GLEN OAK ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-6130
Mailing Address - Country:US
Mailing Address - Phone:563-556-0848
Mailing Address - Fax:563-557-4447
Practice Address - Street 1:220 W 7TH ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-2375
Practice Address - Country:US
Practice Address - Phone:563-557-4444
Practice Address - Fax:563-557-4447
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA045351163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0053629Medicaid