Healthcare Provider Details

I. General information

NPI: 1669763181
Provider Name (Legal Business Name): SHERRY KHURANA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 LAFAYETTE RD
EVANSDALE IA
50707-1129
US

IV. Provider business mailing address

3701 LAFAYETTE RD
EVANSDALE IA
50707-1129
US

V. Phone/Fax

Practice location:
  • Phone: 319-274-7060
  • Fax: 319-233-1156
Mailing address:
  • Phone: 319-274-7060
  • Fax: 319-233-1156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-42296
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: