Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 003042 | MO |
NPI | 1013089226 |
---|---|
Provider Name | Sherry Lynn Cauley |
First Address | Park Hills, MO 63601-0397 |
Second Address | Park Hills, MO 63601-2079 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
9181347 | (05) | MO |