| Doctor Name: | SHERRY LYNN ROUSE |
| NPI Number: | 1194047167 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | R0097115 |
| Business Practice Address: | 103 N Wheeler Ave Sallisaw, OK - 749554617 |
| Business Phone Number: | 9187757751 |
| Business Fax Number: | 9187757932 |
| Mailing Address: | Rr 2 Box 179-1, VIAN |
| State: | OK |
| Postal Code: | 749629265 |
| Phone Number: | 9187738534 |
| Fax Number: | 9187757932 |
| NPI Enumeration Date: | 02/18/2010 |
| NPI Last Update Date: | 02/18/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA2000X |
| License Number: | R0097115 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Administrator |
| Taxonomy Definition: | |