Provider Demographics
NPI:1326271404
Name:CORRIVEAU, SHERRI LYNN
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:LYNN
Last Name:CORRIVEAU
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 1:4000 N DIXIE HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-4650
Mailing Address - Country:US
Mailing Address - Phone:702-505-4183
Mailing Address - Fax:
Practice Address - Street 1:4000 N DIXIE HWY STE 3
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-4650
Practice Address - Country:US
Practice Address - Phone:270-505-8143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator