Healthcare Provider Details

I. General information

NPI: 1760772016
Provider Name (Legal Business Name): JAMES NANCE SHERER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 11/01/2024
Certification Date: 11/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8162 MANITOBA ST UNIT 301
PLAYA DEL REY CA
90293-8643
US

IV. Provider business mailing address

8162 MANITOBA ST UNIT 301
PLAYA DEL REY CA
90293-8643
US

V. Phone/Fax

Practice location:
  • Phone: 310-985-1843
  • Fax:
Mailing address:
  • Phone: 310-985-1843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9279250
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberNA4408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: