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NPI Code Detail

MEDICARE: SHERRYL LYNN BOIVIN

MEDICARE:   SHERRYL LYNN BOIVIN
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
1163W00000XRegistered Nurse172936-030WI

General Provider Information

NPI Number : 1790112282
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRYL LYNN BOIVIN
Provider Business Mailing Address
First Line : 1913 W KIMBERLY AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-5025
Country : US
Telephone Number : 414-217-3898
Fax Number :
Provider Business Practice Location Address
First Line : 1913 W KIMBERLY AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53221-5025
Country : US
Telephone Number : 414-217-3898
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2013
Last Update Date : 09/30/2013

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Directions to “ SHERRYL LYNN BOIVIN ” Practice Location

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