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General NPI Number Information
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NPI Number | 1972925550
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Entity Type | Individual
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Provider Name | KASEY SHERIDAN APRN
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Gender | Female
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Dates
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Enumeration Date | 01/15/2014
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 3871 E HIGHWAY 98 STE 101
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City | PORT SAINT JOE
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State | FL
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Zip | 32456-5302
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Country | US
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Telephone | 850-705-6209
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Fax | 850-952-0902
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Provider Business Mailing Address
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Address Line | 3871 E HIGHWAY 98 STE 101
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City | PORT SAINT JOE
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State | FL
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Zip | 32456-5302
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Country | US
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Telephone | 850-705-6209
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Fax | 850-952-0902
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 201547
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2009024224
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9318530
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 11046251
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License Number State | FL
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