Provider Demographics
NPI:1992942205
Name:PEABODY, SHERI ANN (MSN APN-BC)
Entity type:Individual
Prefix:MS
First Name:SHERI
Middle Name:ANN
Last Name:PEABODY
Suffix:
Gender:F
Credentials:MSN APN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CAPTIAL DRIVE SUITE 3-134
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067
Mailing Address - Country:US
Mailing Address - Phone:860-830-2473
Mailing Address - Fax:866-383-8532
Practice Address - Street 1:400 CAPITAL DRIVE SUITE 3-134
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067
Practice Address - Country:US
Practice Address - Phone:860-830-2473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003982363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health