Provider Demographics
NPI:1861219495
Name:WILLSEY, SHERRI LYNN (LPN)
Entity type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LYNN
Last Name:WILLSEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 KINGDOM RD
Mailing Address - Street 2:
Mailing Address - City:JORDANVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13361-2600
Mailing Address - Country:US
Mailing Address - Phone:315-985-3670
Mailing Address - Fax:
Practice Address - Street 1:FRANKFORT-SCHUYLER SCHOOL DISTRICT
Practice Address - Street 2:605 PALMER STREET
Practice Address - City:FRANKFORT
Practice Address - State:NY
Practice Address - Zip Code:13340
Practice Address - Country:US
Practice Address - Phone:315-895-7491
Practice Address - Fax:315-895-4102
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY319261-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse