Provider Demographics
NPI:1336605286
Name:BIRD, CHERYL KAY (NNP-BC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:KAY
Last Name:BIRD
Suffix:
Gender:F
Credentials:NNP-BC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:KAY
Other - Last Name:MORRISSETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 856
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21705-0856
Mailing Address - Country:US
Mailing Address - Phone:240-566-1600
Mailing Address - Fax:
Practice Address - Street 1:1500 FOREST GLEN RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-1460
Practice Address - Country:US
Practice Address - Phone:240-566-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD363LN0000X363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal