Provider Demographics
NPI:1194872549
Name:HARGRAVES, SHERRI (RN)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:HARGRAVES
Suffix:
Gender:F
Credentials:RN
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 346
Mailing Address - Street 2:
Mailing Address - City:MCGEHEE
Mailing Address - State:AR
Mailing Address - Zip Code:71654-0346
Mailing Address - Country:US
Mailing Address - Phone:870-501-0220
Mailing Address - Fax:
Practice Address - Street 1:2410 HWY 65 N
Practice Address - Street 2:
Practice Address - City:MCGEHEE
Practice Address - State:AR
Practice Address - Zip Code:71654
Practice Address - Country:US
Practice Address - Phone:870-222-3107
Practice Address - Fax:870-222-4301
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR63252163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse