Provider Demographics
NPI:1245770189
Name:DEAN, SHERI
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 GASTON PL
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8623
Mailing Address - Country:US
Mailing Address - Phone:801-920-5561
Mailing Address - Fax:
Practice Address - Street 1:7702 GASTON PL
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8623
Practice Address - Country:US
Practice Address - Phone:801-920-5561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-26
Last Update Date:2017-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRN225561363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily