Provider Demographics
NPI:1215735352
Name:GORE, SIERRA (BSN, RN)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:GORE
Suffix:
Gender:
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:761 JOE MORRIS RD
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-7614
Mailing Address - Country:US
Mailing Address - Phone:270-218-7043
Mailing Address - Fax:
Practice Address - Street 1:761 JOE MORRIS RD
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-7614
Practice Address - Country:US
Practice Address - Phone:270-218-7043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1167531163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice