Provider Demographics
NPI:1750867305
Name:PEARSON, SHERRY MARIE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:MARIE
Last Name:PEARSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14237 JARRETTSVILLE PIKE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1403
Mailing Address - Country:US
Mailing Address - Phone:410-650-4734
Mailing Address - Fax:
Practice Address - Street 1:14237 JARRETTSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:MD
Practice Address - Zip Code:21131-1403
Practice Address - Country:US
Practice Address - Phone:410-650-4734
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR177664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily