Healthcare Provider Details

I. General information

NPI: 1326965948
Provider Name (Legal Business Name): KARLYN RENEE SHEROKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 EMMORTON RD
BEL AIR MD
21015-6256
US

IV. Provider business mailing address

30 SKYLINE DR
CONOWINGO MD
21918-1504
US

V. Phone/Fax

Practice location:
  • Phone: 443-803-1400
  • Fax:
Mailing address:
  • Phone: 443-752-7683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberA03217
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: