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Individual

SHERRY L SHIRE-MISNIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
2500 INTERPLEX DR, TREVOSE, PA 19053-6943
(267) 991-7601
(267) 991-7618
Mailing address
41 UNIVERSITY DR, SUITE 300, NEWTOWN, PA 18940-1873
(215) 710-5522
(215) 710-5181

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
UP006975C
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1030059990001
PA
01
2842578
CIGNA PA
PA
01
30205734
KEYSTONE FIRST
PA
01
3078467
HIGHMARK BLUE SHIELD
PA
01
3931789000
KEYSTONE IBC
PA
01
4692564
AETNA
PA
01
P01404986
RAILROAD MEDICARE
PA
Enumeration date
02/03/2009
Last updated
11/30/2021
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