Provider Demographics
NPI:1780329565
Name:BEARDON, SHERRELLE HAWKINS (RN)
Entity type:Individual
Prefix:
First Name:SHERRELLE
Middle Name:HAWKINS
Last Name:BEARDON
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 1:8246 BRENNEN DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-5751
Mailing Address - Country:US
Mailing Address - Phone:225-324-0954
Mailing Address - Fax:225-261-9442
Practice Address - Street 1:8246 BRENNEN DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818-5751
Practice Address - Country:US
Practice Address - Phone:225-324-0954
Practice Address - Fax:225-261-9442
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA114381163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health