Provider Demographics
NPI:1366481137
Name:SHERRILL, KATHARINE (PAC)
Entity Type:Individual
Prefix:
First Name:KATHARINE
Middle Name:
Last Name:SHERRILL
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 UNION ST
Mailing Address - Street 2:MAINE COAST MEMORIAL HOSPITAL
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-1586
Mailing Address - Country:US
Mailing Address - Phone:207-664-5340
Mailing Address - Fax:207-664-5338
Practice Address - Street 1:50 UNION ST
Practice Address - Street 2:MAINE COAST MEMORIAL HOSPITAL
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-1586
Practice Address - Country:US
Practice Address - Phone:207-664-5340
Practice Address - Fax:207-664-5338
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA-494363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEAP073302Medicare PIN
MES24269Medicare UPIN
MEAP073301Medicare PIN