Sherry Blakney-Johnson, LPN
Individual provider Active NPI Licensed Practical Nurse · Fort Leavenworth, KS
NPI 1245540228 · NPPES record last updated Oct 8, 2010
Key facts
- NPI
- 1245540228
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 2010018119 (MO)
- Practice address
- 550 Pope Avenue
United States Army Medical Department Activity
Fort Leavenworth, KS 66027-2332 - Phone
- (999) 999-9999
- NPI assigned
- Oct 8, 2010
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24-40168-081 | KS | MD | Licensed Practical Nurse |
| 2010018119 | MO | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 2010018119 | MO | Yes |
| Licensed Practical Nurse | 164W00000X | 24-40168-081 | KS |
Addresses
Primary practice location
550 Pope Avenue
United States Army Medical Department Activity
Fort Leavenworth, KS 66027-2332
Mailing address
9417 North Gower Avenue
Kansas City, MO 64154-1293
Phone (972) 767-7472
Other providers in Fort Leavenworth, KS
- John Duane Benz
- Brandy Leigh Berdou
- Richard A Bergstrand
- Dana Bilik
- Robert Allen Bischoff
- Tracy Katherine Bono-Johnson
- Diane Marie Booth
- Randy E Bradford
- Jennifer Klein Brewster
- Stephanie Renee Brooks
All providers in Fort Leavenworth, KS · Licensed Practical Nurse in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.