Provider Demographics
NPI:1396410403
Name:PIASECKI, SHERRY LYNNE (APRN)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:LYNNE
Last Name:PIASECKI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2177 SE OCEAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3305
Mailing Address - Country:US
Mailing Address - Phone:772-281-1520
Mailing Address - Fax:772-210-5313
Practice Address - Street 1:2177 SE OCEAN BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3305
Practice Address - Country:US
Practice Address - Phone:772-281-1520
Practice Address - Fax:772-210-5313
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11014477363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily