Healthcare Provider Details

I. General information

NPI: 1346295102
Provider Name (Legal Business Name): SHERRIE LYNN WEEKS ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 LENGYEL HALL UNIVERSITY OF MAINE
ORONO ME
04469-0001
US

IV. Provider business mailing address

34 BROADWAY
ORONO ME
04473-4017
US

V. Phone/Fax

Practice location:
  • Phone: 207-581-2442
  • Fax: 207-581-1206
Mailing address:
  • Phone: 207-581-2442
  • Fax: 207-581-1206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT47
License Number StateME

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: