Healthcare Provider Details

I. General information

NPI: 1598209553
Provider Name (Legal Business Name): SHERI HYDER COUCH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2016
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 S WARNER RD STE 100
WAYNE PA
19087-2127
US

IV. Provider business mailing address

165 TURNBERRY WAY
PINEHURST NC
28374-8509
US

V. Phone/Fax

Practice location:
  • Phone: 610-784-8297
  • Fax:
Mailing address:
  • Phone: 315-489-5632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5009150
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5009150
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: