MEDICARE: MRS. SHERRY MARIE PEARSON NP-C

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	R177664	MD

General Provider Information

NPI Number	:	1750867305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHERRY MARIE PEARSON NP-C

Provider Business Mailing Address
First Line	:	14237 JARRETTSVILLE PIKE
Second Line	:
City	:	PHOENIX
State	:	MD
Zip	:	21131-1403
Country	:	US
Telephone Number	:	410-650-4734
Fax Number	:

Provider Business Practice Location Address
First Line	:	14237 JARRETTSVILLE PIKE
Second Line	:
City	:	PHOENIX
State	:	MD
Zip	:	21131-1403
Country	:	US
Telephone Number	:	410-650-4734
Fax Number	:

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

Provider Enumeration Date	:	07/17/2018
Last Update Date	:	05/13/2020

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