Provider Demographics
NPI:1023268844
Name:HENRY, SHERRY ANN (RN)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:HENRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5918 BUSH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-3968
Mailing Address - Country:US
Mailing Address - Phone:170-639-3253
Mailing Address - Fax:
Practice Address - Street 1:4141 N MIAMI AVE STE 209
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-2868
Practice Address - Country:US
Practice Address - Phone:130-543-9121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN154648163W00000X
AL1-108353163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse