Provider Demographics
NPI:1982609863
Name:SCHERMERHORN, DONNA K (RNNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:K
Last Name:SCHERMERHORN
Suffix:
Gender:F
Credentials:RNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HARRISON ST
Mailing Address - Street 2:STE 130
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3064
Mailing Address - Country:US
Mailing Address - Phone:315-464-4472
Mailing Address - Fax:
Practice Address - Street 1:550 HARRISON ST
Practice Address - Street 2:STE 130
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3064
Practice Address - Country:US
Practice Address - Phone:315-464-4472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331644363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02060828Medicaid
NY331644OtherLICENSE
NYS50799Medicare UPIN
NY331644OtherLICENSE