Healthcare Provider Details

I. General information

NPI: 1609972462
Provider Name (Legal Business Name): SHERRI ANN MEADOR CRNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 E. PRESIDIO STREET #101
MESA AZ
85215-1165
US

IV. Provider business mailing address

5155 E. EAGLE DRIVE #20730
MESA AZ
85277-3031
US

V. Phone/Fax

Practice location:
  • Phone: 480-706-9430
  • Fax: 480-378-2273
Mailing address:
  • Phone: 480-706-9430
  • Fax: 480-378-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN101426
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: