Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R158889 | MD |
NPI | 1013178862 |
---|---|
Provider Name | Sherla Farrell-Sealey |
First Address | Owings Mills, MD 21117-0166 |
Second Address | Baltimore, MD 21201-4606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2008 |
Last Update Date | 28/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0182915 00 | (05) | MD |