Provider Demographics
NPI:1104333798
Name:MOORER, SHERRELL LYNN
Entity type:Individual
Prefix:
First Name:SHERRELL
Middle Name:LYNN
Last Name:MOORER
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 1:3164 EASTVIEW DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-4225
Mailing Address - Country:US
Mailing Address - Phone:330-743-9595
Mailing Address - Fax:330-743-9590
Practice Address - Street 1:3164 EASTVIEW DRIVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505
Practice Address - Country:US
Practice Address - Phone:330-743-9595
Practice Address - Fax:330-743-9590
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator