Provider Demographics
NPI:1710873138
Name:REDDIC-BURRELL, SHERRY RENE'
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:RENE'
Last Name:REDDIC-BURRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 ELMHURST DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-0760
Mailing Address - Country:US
Mailing Address - Phone:314-473-4619
Mailing Address - Fax:
Practice Address - Street 1:712 ELMHURST DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-0760
Practice Address - Country:US
Practice Address - Phone:314-473-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health