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General NPI Number Information
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NPI Number | 1275629776
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Entity Type | Individual
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Provider Name | MARY BERNADETTE SHEEHY MSN, CRNP
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | FMH WELLNESS CENTER 5500 BUCKEYSTOWN PIKE CORPOHS PROSPECT PLAZA
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City | FREDERICK
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State | MD
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Zip | 21703
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Country | US
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Telephone | 240-379-6011
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Fax | 240-379-6050
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Provider Business Mailing Address
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Address Line | 5161 PERRY
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City | MOUNT AIRY
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State | MD
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Zip | 21771
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Country | US
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Telephone | 410-635-8147
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RO66645
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License Number State | MD
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