Provider Demographics
NPI:1619154994
Name:KLAMM, SHERILYN CATHERINE (RN, APNP, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHERILYN
Middle Name:CATHERINE
Last Name:KLAMM
Suffix:
Gender:F
Credentials:RN, APNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3536 52ND ST
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53144-2662
Mailing Address - Country:US
Mailing Address - Phone:262-764-8555
Mailing Address - Fax:262-842-0004
Practice Address - Street 1:3536 52ND ST
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53144-2662
Practice Address - Country:US
Practice Address - Phone:262-764-8555
Practice Address - Fax:262-842-0004
Is Sole Proprietor?:No
Enumeration Date:2008-01-29
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148570030163W00000X
WI1207733363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100222495Medicaid