MEDICARE: SHERRY HOUSLEY APN

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	363LF0000X	Family Nurse Practitioner	A004368	AR
2	363LF0000X	Family Nurse Practitioner	APRN11017707	FL

General Provider Information

NPI Number	:	1700268042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY HOUSLEY APN

Provider Business Mailing Address
First Line	:	15280 NW 79TH CT STE 200
Second Line	:
City	:	MIAMI LAKES
State	:	FL
Zip	:	33016-5873
Country	:	US
Telephone Number	:	305-558-3724
Fax Number	:

Provider Business Practice Location Address
First Line	:	1185 DUNLAWTON AVE STE 102
Second Line	:
City	:	PORT ORANGE
State	:	FL
Zip	:	32127-2906
Country	:	US
Telephone Number	:	386-760-6601
Fax Number	:	386-222-0769

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

Provider Enumeration Date	:	06/23/2015
Last Update Date	:	09/09/2024

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Directions to “ SHERRY HOUSLEY APN” Practice Location

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