Provider Demographics
NPI:1538140421
Name:SHERRY, SUZANNE VOGT (CRNP MSN)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:VOGT
Last Name:SHERRY
Suffix:
Gender:F
Credentials:CRNP MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 DREW AVE
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2406
Mailing Address - Country:US
Mailing Address - Phone:610-604-4399
Mailing Address - Fax:
Practice Address - Street 1:701 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-1406
Practice Address - Country:US
Practice Address - Phone:484-496-7100
Practice Address - Fax:610-271-9570
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP001471H363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA004149GD6Medicare ID - Type Unspecified