Provider Demographics
NPI:1780282954
Name:KVAMME, SHERRYL FRANCES
Entity type:Individual
Prefix:
First Name:SHERRYL
Middle Name:FRANCES
Last Name:KVAMME
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 1:822 19TH AVE S
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6834
Mailing Address - Country:US
Mailing Address - Phone:701-787-0109
Mailing Address - Fax:
Practice Address - Street 1:3174 36TH AVE S APT 8
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-3538
Practice Address - Country:US
Practice Address - Phone:218-779-6350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant