Provider Demographics
NPI:1225304066
Name:SIMON, SHERI
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:
Last Name:SIMON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHERI
Other - Middle Name:
Other - Last Name:TUCKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 748
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89041-0748
Mailing Address - Country:US
Mailing Address - Phone:775-751-3554
Mailing Address - Fax:
Practice Address - Street 1:2780 HOMESTEAD RD
Practice Address - Street 2:SUITE #201
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-5399
Practice Address - Country:US
Practice Address - Phone:775-727-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner