Provider Demographics
NPI:1801696307
Name:WALLERICH, SHERYL ANN
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:WALLERICH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 AVENUE O
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-3474
Mailing Address - Country:US
Mailing Address - Phone:308-672-6500
Mailing Address - Fax:
Practice Address - Street 1:1019 AVENUE O
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-3474
Practice Address - Country:US
Practice Address - Phone:308-672-6500
Practice Address - Fax:308-672-6500
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion