Provider Demographics
NPI:1528140621
Name:FOOTE, SHERI L (CNM)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:L
Last Name:FOOTE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 4TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-2350
Mailing Address - Country:US
Mailing Address - Phone:415-353-2566
Mailing Address - Fax:415-353-2496
Practice Address - Street 1:1825 4TH ST FL 3
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2350
Practice Address - Country:US
Practice Address - Phone:415-353-2566
Practice Address - Fax:415-353-2496
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041356243176B00000X
GUNP0143367A00000X
CANMW235912367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL041356243OtherIL AMA #
ILMK1218862OtherDEA
IL041356243OtherIL AMA #
IL950150Medicare ID - Type UnspecifiedGROUP #