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General NPI Number Information
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NPI Number | 1639267990
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Entity Type | Individual
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Provider Name | SHERRI LYNN MCDONALD APRN,BC,FNP
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Gender | Female
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 400 S MAIN ST
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City | CHARLESTON
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State | MO
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Zip | 63834-1644
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Country | US
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Telephone | 573-683-3739
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Fax |
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Provider Business Mailing Address
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Address Line | 4287 COUNTY ROAD 634
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63701-8824
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Country | US
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Telephone | 573-334-2097
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 124558
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License Number State | MO
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