Provider Demographics
NPI:1700439577
Name:VERDON, SHERRI A (RN)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:A
Last Name:VERDON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1173
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:AZ
Mailing Address - Zip Code:86547
Mailing Address - Country:US
Mailing Address - Phone:267-616-1464
Mailing Address - Fax:
Practice Address - Street 1:HWY 160 M.P 394.3
Practice Address - Street 2:
Practice Address - City:KAYENTA
Practice Address - State:AZ
Practice Address - Zip Code:86033
Practice Address - Country:US
Practice Address - Phone:928-697-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN333455-L163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency