MEDICARE: SHERRI RICHEY MSN-RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	R45213	NM

General Provider Information

NPI Number	:	1073067989
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRI RICHEY MSN-RN

Provider Business Mailing Address
First Line	:	3500 N SILVER ST
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7286
Country	:	US
Telephone Number	:	575-956-2060
Fax Number	:	575-956-2098

Provider Business Practice Location Address
First Line	:	3500 N SILVER ST
Second Line	:
City	:	SILVER CITY
State	:	NM
Zip	:	88061-7286
Country	:	US
Telephone Number	:	575-956-2060
Fax Number	:	575-956-2098

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2016
Last Update Date	:	08/09/2016

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