Provider Demographics
NPI:1235249632
Name:LOCH, SHERRY LEANN (NP)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:LEANN
Last Name:LOCH
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:4747 N 7TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-3653
Mailing Address - Country:US
Mailing Address - Phone:602-279-7655
Mailing Address - Fax:602-264-1806
Practice Address - Street 1:1840 N 95TH AVE
Practice Address - Street 2:#146
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-4444
Practice Address - Country:US
Practice Address - Phone:623-234-9811
Practice Address - Fax:623-234-9815
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2011-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3122363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ106390Medicare ID - Type Unspecified
AZQ57664Medicare UPIN