Healthcare Provider Details

I. General information

NPI: 1134440829
Provider Name (Legal Business Name): SHERRY VAN METER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 S MEDFORD DR
LUFKIN TX
75901-6260
US

IV. Provider business mailing address

2001 S MEDFORD DR
LUFKIN TX
75901-6260
US

V. Phone/Fax

Practice location:
  • Phone: 936-639-1141
  • Fax: 936-633-5695
Mailing address:
  • Phone: 936-639-1141
  • Fax: 936-633-5695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberN360151780
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number633437
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP60146681
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: