Provider Demographics
NPI:1801984711
Name:WHERRY, DAVID CHARLES SR (RNFA)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CHARLES
Last Name:WHERRY
Suffix:SR
Gender:M
Credentials:RNFA
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:C
Other - Last Name:WHERRY
Other - Suffix:SR
Other - Last Name Type:Other Name
Other - Credentials:RNFA
Mailing Address - Street 1:417 MENSINGER AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350
Mailing Address - Country:US
Mailing Address - Phone:209-573-2727
Mailing Address - Fax:
Practice Address - Street 1:417 MENSINGER AVE
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350
Practice Address - Country:US
Practice Address - Phone:209-573-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284249163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant