Healthcare Provider Details

I. General information

NPI: 1356193445
Provider Name (Legal Business Name): SHERRY DE VELASQUEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2024
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1281 LAMY LN STE 110
MONROE LA
71201-3727
US

IV. Provider business mailing address

PO BOX 1089
HAMMOND LA
70404-1089
US

V. Phone/Fax

Practice location:
  • Phone: 314-374-7370
  • Fax: 318-362-8669
Mailing address:
  • Phone: 985-892-7070
  • Fax: 985-892-7017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number904671
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: