Provider Demographics
NPI:1922598127
Name:PERRONE, SHARYN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:SHARYN
Middle Name:
Last Name:PERRONE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19720 SCENIC HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48167-1918
Mailing Address - Country:US
Mailing Address - Phone:248-719-3449
Mailing Address - Fax:
Practice Address - Street 1:10501 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3375
Practice Address - Country:US
Practice Address - Phone:313-295-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704303978363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner