MEDICARE: MRS. DEBORAH M. MACSHERRY CFNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	335352	NY

General Provider Information

NPI Number	:	1669407300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH M. MACSHERRY CFNP

Provider Business Mailing Address
First Line	:	4 FULLER STREET
Second Line	:
City	:	ALEXANDRIA BAY
State	:	NY
Zip	:	13607-0000
Country	:	US
Telephone Number	:	315-482-1230
Fax Number	:	315-482-4981

Provider Business Practice Location Address
First Line	:	4 FULLER STREET
Second Line	:
City	:	ALEXANDRIA BAY
State	:	NY
Zip	:	13607-0000
Country	:	US
Telephone Number	:	315-482-1230
Fax Number	:	315-482-4981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	12/12/2007

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