Healthcare Provider Details

I. General information

NPI: 1255208955
Provider Name (Legal Business Name): SHERINE MEQUELL EADDY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. SHERINE MEQUELL TRUITT

II. Dates (important events)

Enumeration Date: 10/20/2025
Last Update Date: 10/24/2025
Certification Date: 10/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 E PULASKI HWY
ELKTON MD
21921-6435
US

IV. Provider business mailing address

311 ACASTA DR
MIDDLETOWN DE
19709-9738
US

V. Phone/Fax

Practice location:
  • Phone: 443-485-6213
  • Fax:
Mailing address:
  • Phone: 302-293-6367
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0013330
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: