Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | F02200904 | CO |
NPI | 1053907782 |
---|---|
Provider Name | Audrey Sherman |
First Address | Castle Pines, CO 80108-9141 |
Second Address | Castle Pines, CO 80108-9141 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2020 |
Last Update Date | 16/12/2020 |