Sherilyn K Clark, RN
Individual provider Active NPI Administrator Registered Nurse · Ellington, MO
NPI 1467533604 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1467533604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Administrator Registered Nurse 163WA2000X
- License
- 054701 (MO)
- Practice address
- 110 S. 2ND St.
Ellington, MO 63638 - Phone
- (573) 663-2313
- Fax
- (573) 663-2441
- NPI assigned
- Oct 17, 2006
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 054701 | MO | MD | Administrator Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Administrator Registered Nurse | 163WA2000X | 054701 | MO | Yes |
Addresses
Primary practice location
110 S. 2ND St.
Ellington, MO 63638
Mailing address
108 Pine Lane
Van Buren, MO 63965
Phone (573) 323-8264
Other providers in Ellington, MO
- Leigh Anne Brown
- Browns Pharmacy Inc
- Sydnee Buller
- Korey Michael Burrow
- Lori Campbell
- Deelaney Rae-Ann Crocker
- Bradley R Daniel
- Brooklynn Renee Dement
- Natalie Donnell
- Dr. Stephen C. Waller, DDS, LLC
All providers in Ellington, MO · Administrator Registered Nurse in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.