Provider Demographics
NPI:1255662649
Name:FERRELL, SHERRY D (ANP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:D
Last Name:FERRELL
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 OMEGA DR STE 208
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2075
Mailing Address - Country:US
Mailing Address - Phone:817-465-5881
Mailing Address - Fax:817-465-6336
Practice Address - Street 1:6100 HARRIS PKWY STE 285
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4127
Practice Address - Country:US
Practice Address - Phone:817-263-5864
Practice Address - Fax:817-263-3791
Is Sole Proprietor?:No
Enumeration Date:2010-01-25
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX621587363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L25923Medicare PIN
TX8L25918Medicare PIN
TX8L25924Medicare PIN