MEDICARE: MICHELLE SHARISSE CRIDER APRN, FNP-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	363LF0000X	Family Nurse Practitioner	1214298	TX

General Provider Information

NPI Number	:	1811861354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE SHARISSE CRIDER APRN, FNP-BC

Provider Business Mailing Address
First Line	:	5830 CEDAR HILL WAY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-5530
Country	:	US
Telephone Number	:	210-391-1595
Fax Number	:

Provider Business Practice Location Address
First Line	:	5830 CEDAR HILL WAY
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78253-5530
Country	:	US
Telephone Number	:	210-391-1595
Fax Number	:

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

Provider Enumeration Date	:	09/29/2025
Last Update Date	:	09/29/2025

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