Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 090007034N6 | OR |
N | 363LC1500X | Nurse Practitioner - Community Health | 090007034N6 | OR |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 090007034N6 | OR |
NPI | 1427065234 |
---|---|
Provider Name | Sheryl Ann Hedges |
First Address | Portland, OR 97204 |
Second Address | Portland, OR 97236 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 26/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
292317 | (05) | OR |
S93986 | (02) |