Basic Information
| Provider Information | |||||||||
| NPI: | 1023495025 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALLAWAY | ||||||||
| FirstName: | SHERI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 306 E CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | HORSESHOE BEND | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725123718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709943103 | ||||||||
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| Practice Location | |||||||||
| Address1: | 306 E CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | HORSESHOE BEND | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725123718 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8709943103 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2015 | ||||||||
| LastUpdateDate: | 04/29/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 373H00000X | Y | Nursing Service Related Providers | Day Training/Habilitation Specialist |
No ID Information.