Provider Demographics
NPI:1104310796
Name:WILLIAMS, SHERRY
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 515
Mailing Address - Street 2:
Mailing Address - City:ESTHERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:51334-0515
Mailing Address - Country:US
Mailing Address - Phone:712-362-5231
Mailing Address - Fax:
Practice Address - Street 1:200 6TH ST
Practice Address - Street 2:
Practice Address - City:GRUVER
Practice Address - State:IA
Practice Address - Zip Code:51334-8518
Practice Address - Country:US
Practice Address - Phone:712-362-5231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker