Healthcare Provider Details
I. General information
NPI: 1225282049
Provider Name (Legal Business Name): NICOLE M SHERER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/06/2008
Last Update Date: 06/20/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
124 SAGAMORE PKWY W
WEST LAFAYETTE IN
47906-1569
US
IV. Provider business mailing address
2845 PGA BLVD
PALM BEACH GARDENS FL
33410-2910
US
V. Phone/Fax
- Phone: 765-463-6722
- Fax: 765-463-0905
- Phone: 407-875-2080
- Fax: 407-650-3455
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | ARNP9436144 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 71002790A |
| License Number State | IN |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 71002790A |
| License Number State | IN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: