Provider Demographics
NPI:1588443147
Name:RYERSON, SEHILA R
Entity type:Individual
Prefix:
First Name:SEHILA
Middle Name:R
Last Name:RYERSON
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 1:135 BLITHEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01604-2634
Mailing Address - Country:US
Mailing Address - Phone:508-873-5048
Mailing Address - Fax:
Practice Address - Street 1:135 BLITHEWOOD AVE
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01604-2634
Practice Address - Country:US
Practice Address - Phone:508-826-7821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN102494164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse