Provider Demographics
NPI:1740446012
Name:WARDLE, SHARI ANNE
Entity type:Individual
Prefix:MRS
First Name:SHARI
Middle Name:ANNE
Last Name:WARDLE
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 1:5256 MISSION BLVD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92509-4624
Mailing Address - Country:US
Mailing Address - Phone:951-955-5327
Mailing Address - Fax:951-955-5329
Practice Address - Street 1:5256 MISSION BLVD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92509-4624
Practice Address - Country:US
Practice Address - Phone:951-955-5327
Practice Address - Fax:951-955-5329
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA603881163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health