Provider Demographics
NPI:1720815616
Name:SPERRY, GEORGIA ANN (BSN, RN)
Entity type:Individual
Prefix:MRS
First Name:GEORGIA
Middle Name:ANN
Last Name:SPERRY
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7959 TELEGRAPH RD TRLR 48
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-1837
Mailing Address - Country:US
Mailing Address - Phone:419-371-8337
Mailing Address - Fax:
Practice Address - Street 1:7555 HARMANS RD
Practice Address - Street 2:
Practice Address - City:HARMANS
Practice Address - State:MD
Practice Address - Zip Code:21077-1537
Practice Address - Country:US
Practice Address - Phone:443-720-3197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN423975163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health