MEDICARE: SHERISE ULMER 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	626468	NY

General Provider Information

NPI Number	:	1598026833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERISE ULMER RN

Provider Business Mailing Address
First Line	:	720 FINCHINGFIELD LN
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-9436
Country	:	US
Telephone Number	:	585-727-0960
Fax Number	:

Provider Business Practice Location Address
First Line	:	720 FINCHINGFIELD LN
Second Line	:
City	:	WEBSTER
State	:	NY
Zip	:	14580-9436
Country	:	US
Telephone Number	:	585-727-0960
Fax Number	:

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

Provider Enumeration Date	:	06/04/2012
Last Update Date	:	06/04/2012

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