Provider Demographics
NPI:1912971425
Name:ADAMS, SHERRY ANN (ARNP)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8687 E VIA DE VENTURA STE 310
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3351
Mailing Address - Country:US
Mailing Address - Phone:480-970-9097
Mailing Address - Fax:480-970-5318
Practice Address - Street 1:520 11TH ST NW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52405-3811
Practice Address - Country:US
Practice Address - Phone:319-398-3562
Practice Address - Fax:319-398-3501
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2061062363LF0000X, 363LP0808X
IAG147717363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009051200Medicaid
FLAD372VMedicare UPIN
FLAE372ZMedicare UPIN