Provider Demographics
NPI:1013178862
Name:FARRELL-SEALEY, SHERLA (CRNP)
Entity Type:Individual
Prefix:
First Name:SHERLA
Middle Name:
Last Name:FARRELL-SEALEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:SHERLA
Other - Middle Name:
Other - Last Name:FARRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 166
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-0166
Mailing Address - Country:US
Mailing Address - Phone:301-379-1754
Mailing Address - Fax:443-558-3302
Practice Address - Street 1:827 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4606
Practice Address - Country:US
Practice Address - Phone:301-379-1754
Practice Address - Fax:443-558-3302
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR158889363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0182915 00Medicaid
MD128580Y56Medicare PIN