Healthcare Provider Details
I. General information
NPI: 1851212070
Provider Name (Legal Business Name): SHEREL THYME LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
332 BIRNIE AVE
SPRINGFIELD MA
01107-1104
US
IV. Provider business mailing address
286 BENTON DR
EAST LONGMEADOW MA
01028-3119
US
V. Phone/Fax
- Phone: 413-439-2189
- Fax: 413-451-0037
- Phone: 844-243-4357
- Fax: 413-451-0037
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 164W00000X |
| Taxonomy | Licensed Practical Nurse |
| License Number | LN1006691 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: