Provider Demographics
NPI:1043982358
Name:FARRELL, SHERRY (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:FARRELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 MARTZ LN
Mailing Address - Street 2:
Mailing Address - City:LAVALE
Mailing Address - State:MD
Mailing Address - Zip Code:21502-7705
Mailing Address - Country:US
Mailing Address - Phone:240-580-5403
Mailing Address - Fax:
Practice Address - Street 1:925 BISHOP WALSH RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1845
Practice Address - Country:US
Practice Address - Phone:301-759-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR189540363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily