Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | APN0990586 | CO |
N | 363LC1500X | Nurse Practitioner - Community Health | APN0990586 | CO |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | NP0990586 | CO |
NPI | 1477892321 |
---|---|
Provider Name | Ms. Sherry Lynn Ketner |
First Address | Durango, CO 81303-8276 |
Second Address | Durango, CO 81303-3409 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2013 |
Last Update Date | 12/01/2018 |