Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9258728 | FL |
NPI | 1013253590 |
---|---|
Provider Name | Mrs. Shanna Ann Sherman |
First Address | St Petersburg, FL 33714-1326 |
Second Address | St Petersburg, FL 33701-4804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2013 |
Last Update Date | 20/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
007950100 | (05) | FL |