Provider Demographics
NPI:1932709912
Name:TITTELMAYER, SHERI LYNN
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNN
Last Name:TITTELMAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 NEWTOWN YARDLEY RD STE 115
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-4500
Mailing Address - Country:US
Mailing Address - Phone:215-504-8900
Mailing Address - Fax:
Practice Address - Street 1:760 NEWTOWN YARDLEY RD STE 115
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4500
Practice Address - Country:US
Practice Address - Phone:215-504-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP022628363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily