Provider Demographics
NPI:1508051285
Name:CRISS, SHERRIE LYNNE (NP)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:LYNNE
Last Name:CRISS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13250 HAZEL DELL PKWY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8521
Mailing Address - Country:US
Mailing Address - Phone:317-843-9475
Mailing Address - Fax:317-843-9476
Practice Address - Street 1:13250 HAZEL DELL PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8521
Practice Address - Country:US
Practice Address - Phone:317-843-9475
Practice Address - Fax:317-843-9476
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28080748A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics