1104911023 NPI number — SHERRY B MORRISSETTE D.C., D.A.C.N.B.

Table of content: SHERRY B MORRISSETTE D.C., D.A.C.N.B. (NPI 1104911023)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104911023 NPI number — SHERRY B MORRISSETTE D.C., D.A.C.N.B.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORRISSETTE
Provider First Name:
SHERRY
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C., D.A.C.N.B.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104911023
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 NOOSENECK HILL RD
Provider Second Line Business Mailing Address:
A
Provider Business Mailing Address City Name:
WEST GREENWICH
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02817-1511
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-397-9948
Provider Business Mailing Address Fax Number:
401-397-6218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 NOOSENECK HILL RD
Provider Second Line Business Practice Location Address:
A
Provider Business Practice Location Address City Name:
WEST GREENWICH
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02817-1511
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-397-9948
Provider Business Practice Location Address Fax Number:
401-397-6218
Provider Enumeration Date:
10/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111NN0400X , with the licence number:  DCP00351 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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