Provider Demographics
NPI:1750421947
Name:KAHN, SHERRY L (MS, RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:L
Last Name:KAHN
Suffix:
Gender:F
Credentials:MS, RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHILDRENS PLZ
Mailing Address - Street 2:DEPARTMENT OF SURGERY & SPRINGBORO URGENT CARE
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1898
Mailing Address - Country:US
Mailing Address - Phone:937-641-3000
Mailing Address - Fax:937-641-4952
Practice Address - Street 1:5079 MAD RIVER RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2138
Practice Address - Country:US
Practice Address - Phone:937-938-8130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP08431363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics