Provider Demographics
NPI:1518114222
Name:SPARLIN, SHERYL (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:SPARLIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:
Other - Last Name:BOUCHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:C/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT
Mailing Address - Street 2:PO BOX 7291
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-7291
Mailing Address - Country:US
Mailing Address - Phone:207-777-8560
Mailing Address - Fax:207-777-8800
Practice Address - Street 1:900 BROADWAY
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-1900
Practice Address - Country:US
Practice Address - Phone:207-907-1187
Practice Address - Fax:207-907-1189
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81925363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily