Healthcare Provider Details

I. General information

NPI: 1972753648
Provider Name (Legal Business Name): SHERRI EADOR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S ADAMS ST
NEVADA MO
64772-3210
US

IV. Provider business mailing address

900 S ADAMS ST
NEVADA MO
64772-3210
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-6015
  • Fax: 417-667-3007
Mailing address:
  • Phone: 417-667-6015
  • Fax: 417-667-3007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number138234
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: