Provider Demographics
NPI:1477914976
Name:SHEERIN, OLIVIA (PA-C)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:SHEERIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:OLIVIA
Other - Middle Name:
Other - Last Name:GROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:1 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:OAK BLUFFS
Mailing Address - State:MA
Mailing Address - Zip Code:02557-1406
Mailing Address - Country:US
Mailing Address - Phone:508-684-4500
Mailing Address - Fax:508-684-4502
Practice Address - Street 1:1 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:OAK BLUFFS
Practice Address - State:MA
Practice Address - Zip Code:02557-1406
Practice Address - Country:US
Practice Address - Phone:508-684-4500
Practice Address - Fax:508-684-4502
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4059133V00000X
MAPA7789363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered