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General NPI Number Information
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NPI Number | 1518952399
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Entity Type | Individual
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Provider Name | SHERRI LYN DERR MSN CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/16/2005
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Last Update Date | 11/05/2012
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Provider Practice Location Address
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Address Line | 101 W 9TH ST
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City | BERWICK
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State | PA
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Zip | 18603-3024
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Country | US
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Telephone | 570-759-2600
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Fax | 570-759-3229
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Provider Business Mailing Address
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Address Line | PO BOX 613 5 SQUIRE LANE
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City | MIFFLINVILLE
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State | PA
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Zip | 18631-0613
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Country | US
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Telephone | 570-752-1184
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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 | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | RN235197L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | VP004997B
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License Number State | PA
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