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General NPI Number Information
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NPI Number | 1780697904
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Entity Type | Individual
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Provider Name | SHERRIE HERNISEY P.A..
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 4379 KATHLEEN DR
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City | PIGEON
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State | MI
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Zip | 48755-9631
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Country | US
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Telephone | 810-334-4838
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Fax |
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Provider Business Mailing Address
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Address Line | 4379 KATHLEEN DR
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City | PIGEON
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State | MI
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Zip | 48755-9631
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Country | US
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Telephone | 810-334-4838
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Fax | 989-438-5910
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 5601003339
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License Number State | MI
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