Provider Demographics
NPI:1841092277
Name:BROCKETT, SHERI (RN IBCLC)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:BROCKETT
Suffix:
Gender:
Credentials:RN IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8271 N TULLIS AVE UNIT 231
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64158-7713
Mailing Address - Country:US
Mailing Address - Phone:816-210-1148
Mailing Address - Fax:
Practice Address - Street 1:9051 NE 81ST TER STE 100
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1168
Practice Address - Country:US
Practice Address - Phone:816-792-1170
Practice Address - Fax:816-792-1170
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2009021770163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant