Healthcare Provider Details

I. General information

NPI: 1518709260
Provider Name (Legal Business Name): SHERRI MEDINA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3409 BELLCREST WAY
CELINA TX
75009-1757
US

IV. Provider business mailing address

5899 PRESTON RD STE 404
FRISCO TX
75034-9590
US

V. Phone/Fax

Practice location:
  • Phone: 214-554-1781
  • Fax:
Mailing address:
  • Phone: 214-618-0588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number666025
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: