Individual
SHERRY S CANTRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1434 SHELBY ST, INDIANAPOLIS, IN 46203-1945
(317) 655-3200
(317) 655-3210
Mailing address
8910 PURDUE RD, STE 500, INDIANAPOLIS, IN 46268-3161
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
71001433A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000502343
ANTHEM
IN
05
—
200399840
—
IN
Enumeration date
05/10/2006
Last updated
07/22/2011
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