Sheri Marie Gordon
Individual provider Active NPI Licensed Practical Nurse · Granville, NY
NPI 1346573680 · NPPES record last updated Sep 17, 2009
Key facts
- NPI
- 1346573680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 294167-1 (NY)
- Practice address
- 65 Dublin Rd
Granville, NY 12832-5004 - Phone
- (518) 642-1719
- Fax
- (518) 642-1719
- NPI assigned
- Sep 17, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 294167-1 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 294167-1 | NY | Yes |
Addresses
Primary practice location
65 Dublin Rd
Granville, NY 12832-5004
Mailing address
65 Dublin Rd
Granville, NY 12832-5004
Phone (518) 642-1719
Other providers in Granville, NY
- Freds Pharmacy LLC
- Freds Pharmacy LLC
- Ragini Ganjoo
- Deborah Marie Garrelts
- Glens Falls Hospital Inc
- Granville Central School District
- Granville Nursing and Rehabilitation Center LLC
- Granville Rescue Squad, Inc.
- Breanne K Greenough
- Ann Marie Gregory
All providers in Granville, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2009. 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.