Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP144397 | TX |
NPI | 1003437716 |
---|---|
Provider Name | Jessie Rulan Sherrard |
First Address | Denton, TX 76210-6803 |
Second Address | Denton, TX 76210-6803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2020 |
Last Update Date | 22/07/2020 |