Healthcare Provider Details

I. General information

NPI: 1316474315
Provider Name (Legal Business Name): SCHERRA BOARMAN CRNP-PMH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S HANOVER ST FL 6
BALTIMORE MD
21225-1233
US

IV. Provider business mailing address

695 KIRKCALDY WAY
ABINGDON MD
21009-2417
US

V. Phone/Fax

Practice location:
  • Phone: 443-792-8586
  • Fax:
Mailing address:
  • Phone: 443-903-4974
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberR209746
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberR209746
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: