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Sherri A Robertson

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4209 Lincoln Rd, Hattiesburg, MS 39402-3065

PECOS Enrollment

This provider is enrolled in PECOS as SHERRI ROBERTSON.

Based on the most recent information from CMS, provider Sherri A Robertson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1790894335
Provider Type
Individual
Full Name
Robertson, Sherri A
Credential
DNP, FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
8/29/2006
Last Updated
8/10/2020

Contact Information

Practice Location

4209 Lincoln Rd, Hattiesburg, MS 39402-3065

(601) 705-2896

(601) 264-0732

Mailing Location

415 S 28th Ave, Hattiesburg, MS 39401-7246

(601) 705-2896

(601) 579-5240

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R739582 Mississippi

Provider Identifiers

ID	Description	Issuer
ID 00118300	Description Medicaid	Issuer Unlisted Mississippi
ID 640507572YW	Description Other	Issuer AMERICAN ADMIN GROUP Mississippi

Sherri A Robertson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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