Provider Demographics
NPI:1396116018
Name:SPIRES, SHERRY LYNN (LPN)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:LYNN
Last Name:SPIRES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:LYNN
Other - Last Name:HOLMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:208 ARBOR LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:KY
Mailing Address - Zip Code:42728-8235
Mailing Address - Country:US
Mailing Address - Phone:270-634-4170
Mailing Address - Fax:606-485-4613
Practice Address - Street 1:208 ARBOR LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:KY
Practice Address - Zip Code:42728-8235
Practice Address - Country:US
Practice Address - Phone:270-634-4170
Practice Address - Fax:606-485-4613
Is Sole Proprietor?:No
Enumeration Date:2015-10-08
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2047828164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse