MEDICARE: MS. KRYSTAL E SHERAN PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN11045053	FL

General Provider Information

NPI Number	:	1518816354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRYSTAL E SHERAN PMHNP-BC

Provider Business Mailing Address
First Line	:	1542 KINGSLEY AVE STE 136-137
Second Line	:
City	:	ORANGE PARK
State	:	FL
Zip	:	32073-4586
Country	:	US
Telephone Number	:	904-458-7780
Fax Number	:

Provider Business Practice Location Address
First Line	:	1028 DUNN AVE
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32218-4830
Country	:	US
Telephone Number	:	904-485-6739
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2026
Last Update Date	:	02/23/2026

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