Healthcare Provider Details

I. General information

NPI: 1508961913
Provider Name (Legal Business Name): KATHY SHERMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 04/03/2020
Certification Date: 04/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 E INDIAN SCHOOL ROAD
PHOENIX AZ
85012
US

IV. Provider business mailing address

650 E INDIAN SCHOOL ROAD
PHOENIX AZ
85012
US

V. Phone/Fax

Practice location:
  • Phone: 480-397-2894
  • Fax:
Mailing address:
  • Phone: 480-397-2894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS011653
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: