Provider Demographics
NPI:1760695076
Name:NILSEN, SHERYL ANN (MS RN ANP-C)
Entity Type:Individual
Prefix:MS
First Name:SHERYL
Middle Name:ANN
Last Name:NILSEN
Suffix:
Gender:F
Credentials:MS RN ANP-C
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Mailing Address - Street 1:41 MANHASSET RD
Mailing Address - Street 2:
Mailing Address - City:SOUND BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11789-2919
Mailing Address - Country:US
Mailing Address - Phone:631-744-2155
Mailing Address - Fax:
Practice Address - Street 1:SRU 919 RAINBOW COMMONS
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746
Practice Address - Country:US
Practice Address - Phone:631-421-0408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF303590363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02713275Medicaid
NYF303590OtherNY STATE NP LIC#
NYMN0871283OtherDEA #
NYMN0871283OtherDEA #