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General NPI Number Information
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NPI Number | 1821079542
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Entity Type | Individual
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Provider Name | KATHY SHERMAN NP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 12/09/2016
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Provider Practice Location Address
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Address Line | 3150 E WINDING BROOK RD
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City | FLAGSTAFF
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State | AZ
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Zip | 86001
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Country | US
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Telephone | 480-392-8046
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Fax | 480-987-4441
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Provider Business Mailing Address
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Address Line | PO BOX 29675 DEPT 2025
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City | PHOENIX
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State | AZ
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Zip | 85038
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Country | US
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Telephone | 480-392-8046
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Fax | 480-987-4441
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN124321
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License Number State | AZ
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