Healthcare Provider Details

I. General information

NPI: 1376400556
Provider Name (Legal Business Name): SHERRI SHEROCK CFNC, CHC, CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2026
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 SWEETWATER DR
OREGON OH
43616-3059
US

IV. Provider business mailing address

4860 WASHTENAW AVE STE I
ANN ARBOR MI
48108-3401
US

V. Phone/Fax

Practice location:
  • Phone: 419-540-1877
  • Fax:
Mailing address:
  • Phone: 419-540-1877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: