Provider Demographics
NPI:1578374120
Name:ROYAL, SHERRIE (LPN)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:
Last Name:ROYAL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SAND RUN CEMETERY WAY
Mailing Address - Street 2:
Mailing Address - City:ELKVIEW
Mailing Address - State:WV
Mailing Address - Zip Code:25071-6368
Mailing Address - Country:US
Mailing Address - Phone:814-592-5738
Mailing Address - Fax:
Practice Address - Street 1:900 VIRGINIA ST E STE 400
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-2835
Practice Address - Country:US
Practice Address - Phone:681-313-4759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV41144164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse