Provider Demographics
NPI:1366298002
Name:RUCKER, SHERRI DEANN (500 RYT, BD, PPD)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:DEANN
Last Name:RUCKER
Suffix:
Gender:F
Credentials:500 RYT, BD, PPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16919 BALMORAL
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-2989
Mailing Address - Country:US
Mailing Address - Phone:951-575-5377
Mailing Address - Fax:
Practice Address - Street 1:16919 BALMORAL
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316-2989
Practice Address - Country:US
Practice Address - Phone:951-575-5377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102314374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula