Individual
SHERRY LYNN ROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
103 N WHEELER AVE, SALLISAW, OK 74955-4617
(918) 775-7751
(918) 775-7932
Mailing address
RR 2 BOX 179-1, VIAN, OK 74962-9265
(918) 773-8534
(918) 775-7932
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
R0097115
OK
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R0097115
OK
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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