Provider Demographics
NPI:1487260428
Name:LYNN, SHERRI LEA (DNP, APRN, CNM)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:LEA
Last Name:LYNN
Suffix:
Gender:F
Credentials:DNP, APRN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 STATE ROUTE 147
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:IL
Mailing Address - Zip Code:62995-3804
Mailing Address - Country:US
Mailing Address - Phone:309-338-6669
Mailing Address - Fax:
Practice Address - Street 1:2605 KENTUCKY AVE STE 301
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-3802
Practice Address - Country:US
Practice Address - Phone:270-443-1220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014834367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife