Provider Demographics
NPI:1427326974
Name:BECKER, SHERRILL JUNE (RN)
Entity type:Individual
Prefix:
First Name:SHERRILL
Middle Name:JUNE
Last Name:BECKER
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 1:14784 STATE HIGHWAY 30
Mailing Address - Street 2:PO BOX J
Mailing Address - City:DOWNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13755
Mailing Address - Country:US
Mailing Address - Phone:607-363-2120
Mailing Address - Fax:
Practice Address - Street 1:14784 STATE HIGHWAY 30
Practice Address - Street 2:
Practice Address - City:DOWNSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13755
Practice Address - Country:US
Practice Address - Phone:607-363-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY378092-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse