Healthcare Provider Details

I. General information

NPI: 1538670914
Provider Name (Legal Business Name): EMILY MICHELLE SHERLOCK APN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2017
Last Update Date: 11/04/2020
Certification Date: 11/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3487 W 10TH ST STE B
GREELEY CO
80634-5361
US

IV. Provider business mailing address

3487 W 10TH ST STE B
GREELEY CO
80634-5361
US

V. Phone/Fax

Practice location:
  • Phone: 970-352-4762
  • Fax: 970-352-0040
Mailing address:
  • Phone: 970-352-4762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0993471-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: