MEDICARE: KAREN M. SHERRY NP

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	163W00000X	Registered Nurse	81557-30	WI
2	363LP0200X	Pediatric Nurse Practitioner	5553-33	WI

General Provider Information

NPI Number	:	1679949663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN M. SHERRY NP

Provider Business Mailing Address
First Line	:	2014 N 124TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-2047
Country	:	US
Telephone Number	:	414-259-8072
Fax Number	:

Provider Business Practice Location Address
First Line	:	2014 N 124TH ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53226
Country	:	US
Telephone Number	:	414-259-8072
Fax Number	:

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

Provider Enumeration Date	:	08/13/2015
Last Update Date	:	10/23/2019

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