Basic Information
Provider Information
NPI: 1013009893
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RORER
FirstName: SHERRI
MiddleName: L
NamePrefix: MS.
NameSuffix:  
Credential: LPN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 155
Address2: REA CLINIC
City: CHRISTOPHER
State: IL
PostalCode: 62822
CountryCode: US
TelephoneNumber: 6187242401
FaxNumber: 6187242571
Practice Location
Address1: 300 S MAIN STREET
Address2: ROYALTON COMMUNITY HEALTH CENTER
City: ROYALTON
State: IL
PostalCode: 62983
CountryCode: US
TelephoneNumber: 6189842695
FaxNumber: 6189842589
Other Information
ProviderEnumerationDate: 09/29/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
164W00000X ILY Nursing Service ProvidersLicensed Practical Nurse 

No ID Information.


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