Provider Demographics
NPI:1578948329
Name:SHAFFERY, SHERRI (MSN, RN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:
Last Name:SHAFFERY
Suffix:
Gender:F
Credentials:MSN, RN, FNP-C
Other - Prefix:MS
Other - First Name:SHERRI
Other - Middle Name:
Other - Last Name:TYLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:1313 WILLOW CHASE DR
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5851
Mailing Address - Country:US
Mailing Address - Phone:443-616-7189
Mailing Address - Fax:
Practice Address - Street 1:299 FORT HOYLE RD
Practice Address - Street 2:
Practice Address - City:JOPPA
Practice Address - State:MD
Practice Address - Zip Code:21085-4805
Practice Address - Country:US
Practice Address - Phone:410-612-1553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR134930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily