Basic Information
Provider Information
NPI: 1851776819
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARRISON
FirstName: SHERI
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: FNP
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Mailing Information
Address1: 12101 WOODCREST EXECUTIVE DR
Address2: SUITE 210
City: SAINT LOUIS
State: MO
PostalCode: 631415047
CountryCode: US
TelephoneNumber: 3143170600
FaxNumber: 3143170606
Practice Location
Address1: 3280 DAUPHIN ST
Address2: BUILDING B, SUITE 118
City: MOBILE
State: AL
PostalCode: 366064060
CountryCode: US
TelephoneNumber: 2515454579
FaxNumber: 2512871466
Other Information
ProviderEnumerationDate: 07/20/2015
LastUpdateDate: 07/20/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X1-090899ALY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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