Healthcare Provider Details

I. General information

NPI: 1336605286
Provider Name (Legal Business Name): CHERYL KAY BIRD NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERYL KAY MORRISSETTE RN

II. Dates (important events)

Enumeration Date: 02/15/2019
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1460
US

IV. Provider business mailing address

PO BOX 856
FREDERICK MD
21705-0856
US

V. Phone/Fax

Practice location:
  • Phone: 240-566-1600
  • Fax:
Mailing address:
  • Phone: 240-566-1600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number363LN0000X
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: