Provider Demographics
NPI:1649756305
Name:MOUA, SHERRY (APRN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:
Last Name:MOUA
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:MISS
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:YANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:4140 HERITAGE TRACE PKWY
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5310
Mailing Address - Country:US
Mailing Address - Phone:817-741-7501
Mailing Address - Fax:
Practice Address - Street 1:4140 HERITAGE TRACE PKWY
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-5310
Practice Address - Country:US
Practice Address - Phone:817-741-7353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX822957363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner