Provider Demographics
NPI:1972753648
Name:EADOR, SHERRI (FNP-C)
Entity type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:
Last Name:EADOR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:MO
Mailing Address - Zip Code:64772-3210
Mailing Address - Country:US
Mailing Address - Phone:417-667-6015
Mailing Address - Fax:417-667-3007
Practice Address - Street 1:900 S ADAMS ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:MO
Practice Address - Zip Code:64772-3210
Practice Address - Country:US
Practice Address - Phone:417-667-6015
Practice Address - Fax:417-667-3007
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO138234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO138234OtherSTATE LICENSE