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NPI Code Detail

MEDICARE: KATHERINE RUTH SHERROUSE

MEDICARE: KATHERINE RUTH SHERROUSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1-164653AL

General Provider Information

NPI Number : 1871112680
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE RUTH SHERROUSE
Provider Business Mailing Address
First Line : PO BOX 18428
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35804-8428
Country : US
Telephone Number : 256-705-4224
Fax Number : 256-705-4135
Provider Business Practice Location Address
First Line : 3601 CCI DR NW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35805-2606
Country : US
Telephone Number : 256-705-4224
Fax Number : 256-705-4135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2020
Last Update Date : 12/02/2025

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Directions to “ KATHERINE RUTH SHERROUSE ” Practice Location

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