Provider Demographics
NPI:1487179826
Name:WEST BURGESS, SHERRY ANN (MSN, APRN, PMHNP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:WEST BURGESS
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S WALNUT ST STE 221
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2993
Mailing Address - Country:US
Mailing Address - Phone:812-523-7852
Mailing Address - Fax:812-523-7853
Practice Address - Street 1:415 S WALNUT ST STE 221
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2993
Practice Address - Country:US
Practice Address - Phone:812-523-7852
Practice Address - Fax:812-523-7853
Is Sole Proprietor?:No
Enumeration Date:2017-08-07
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71007361A363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health