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General NPI Number Information
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NPI Number | 1194223743
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Entity Type | Individual
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Provider Name | SHERRIA TRENICE JASPER FNP
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Gender | Female
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Dates
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Enumeration Date | 01/29/2018
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 595 HURRICANE SHOALS RD NW STE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-8762
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Country | US
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Telephone | 404-645-7150
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Fax | 678-433-9152
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Provider Business Mailing Address
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Address Line | 1500 STILL RIDGE LN
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City | LAWRENCEVILLE
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State | GA
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Zip | 30045-2908
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Country | US
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Telephone | 352-303-7024
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN238943
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License Number State | GA
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