MEDICARE: MRS. SHERRY FAYE PYKE 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	28117596A	IN

General Provider Information

NPI Number	:	1912964412
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERRY FAYE PYKE RN

Provider Business Mailing Address
First Line	:	707 PANSY CT
Second Line	:
City	:	BOURBON
State	:	IN
Zip	:	46504-1803
Country	:	US
Telephone Number	:	574-342-7047
Fax Number	:	574-342-7047

Provider Business Practice Location Address
First Line	:	707 PANSY CT
Second Line	:
City	:	BOURBON
State	:	IN
Zip	:	46504-1803
Country	:	US
Telephone Number	:	574-342-7047
Fax Number	:	574-342-7047

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	07/08/2007

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