Provider Demographics
NPI:1720664741
Name:HARPER, SHERRY DELANE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:DELANE
Last Name:HARPER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 BELVEDERE DR
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-8916
Mailing Address - Country:US
Mailing Address - Phone:601-407-0427
Mailing Address - Fax:
Practice Address - Street 1:308 BELVEDERE DR
Practice Address - Street 2:
Practice Address - City:PEARL
Practice Address - State:MS
Practice Address - Zip Code:39208-8916
Practice Address - Country:US
Practice Address - Phone:601-408-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-21
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903996363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner