Provider Demographics
NPI:1457904567
Name:SNYDER-FERGUSON, SHERRY LYNN (RPH)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:LYNN
Last Name:SNYDER-FERGUSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:LYNN
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:4824 N 1200 W
Mailing Address - Street 2:
Mailing Address - City:PARKER CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47368-9590
Mailing Address - Country:US
Mailing Address - Phone:765-730-0877
Mailing Address - Fax:
Practice Address - Street 1:4801 W CLARA LN
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-5548
Practice Address - Country:US
Practice Address - Phone:765-284-3750
Practice Address - Fax:765-288-8243
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017922183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty