Provider Demographics
NPI:1093057358
Name:MASON, SHERRI L (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:L
Last Name:MASON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15588 HUME SCHOOL CT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-5444
Mailing Address - Country:US
Mailing Address - Phone:440-554-6864
Mailing Address - Fax:
Practice Address - Street 1:15588 HUME SCHOOL CT
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20112-5444
Practice Address - Country:US
Practice Address - Phone:440-554-6864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013004941363LF0000X
VA0024172963363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024172963OtherAPRN