Healthcare Provider Details

I. General information

NPI: 1225599681
Provider Name (Legal Business Name): NICOLE BROOKE SHERMAN WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2019
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 N LOOP 288 STE 200
DENTON TX
76209-4958
US

IV. Provider business mailing address

1200 FOX RUN
ARGYLE TX
76226-6388
US

V. Phone/Fax

Practice location:
  • Phone: 940-381-1501
  • Fax: 940-591-7830
Mailing address:
  • Phone: 805-906-5698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1026008
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number95011266
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: