Provider Demographics
NPI:1740868355
Name:AMANKWA, SHERRY (MSN, APRN, FNP -C)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:AMANKWA
Suffix:
Gender:F
Credentials:MSN, APRN, FNP -C
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:
Other - Last Name:AMANKWA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, APRN, FNP -C
Mailing Address - Street 1:14207 PARK CENTER DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5248
Mailing Address - Country:US
Mailing Address - Phone:301-248-5141
Mailing Address - Fax:
Practice Address - Street 1:14207 PARK CENTER DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5248
Practice Address - Country:US
Practice Address - Phone:301-248-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-02
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR213678207Q00000X
MDF02211167207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD881059100Medicaid