Provider Demographics
NPI:1740222983
Name:SHERRY, ANN M (PA)
Entity type:Individual
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First Name:ANN
Middle Name:M
Last Name:SHERRY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:407 S MAIN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VIROQUA
Mailing Address - State:WI
Mailing Address - Zip Code:54665-2057
Mailing Address - Country:US
Mailing Address - Phone:608-637-4230
Mailing Address - Fax:608-637-4214
Practice Address - Street 1:407 S MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-2057
Practice Address - Country:US
Practice Address - Phone:608-637-4230
Practice Address - Fax:608-637-4214
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
WI639363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIS06598Medicare UPIN