Sherry C Davis, N.P.
Individual provider Active NPI Family Nurse Practitioner · Plymouth, IN
NPI 1881616324 · NPPES record last updated Sep 14, 2016
Key facts
- NPI
- 1881616324
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71000035A (IN)
- Practice address
- 2349 Lake Ave
Suite 100
Plymouth, IN 46563-7835 - Phone
- (574) 948-5100
- Fax
- (574) 948-5499
- NPI assigned
- Jul 24, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Joseph Regional Medical Center, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71000035A | IN | Yes |
Addresses
Primary practice location
2349 Lake Ave
Suite 100
Plymouth, IN 46563-7835
Mailing address
707 E Cedar St
Ste 200
South Bend, IN 46617-2057
Phone (574) 335-8700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200813420A | Medicaid | IN |
Other providers in Plymouth, IN
- James Warren Dammon Jr.
- Daniel J. Zych, Inc
- Akacia Darnell
- Kathleen J Davidson
- Donald Davis I
- Ashley De Leon
- Heather Delp
- Dental Center of Plymouth LLC
- Monali Desai
- Diagnostic Medicine P.C.
All providers in Plymouth, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.