MEDICARE: TYLER SHERMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	112981	NE

General Provider Information

NPI Number	:	1396355103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYLER SHERMAN

Provider Business Mailing Address
First Line	:	621 N FRANKLIN ST
Second Line	:
City	:	RED CLOUD
State	:	NE
Zip	:	68970-2260
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	621 N FRANKLIN ST
Second Line	:
City	:	RED CLOUD
State	:	NE
Zip	:	68970-2260
Country	:	US
Telephone Number	:	402-746-5600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	08/06/2020

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Directions to “ TYLER SHERMAN ” Practice Location

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