Provider Demographics
NPI:1003330101
Name:KATINGA, SHERRYL YVONNE (NP)
Entity Type:Individual
Prefix:
First Name:SHERRYL
Middle Name:YVONNE
Last Name:KATINGA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHERRYL
Other - Middle Name:YVONNE
Other - Last Name:DYE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3140 LEGACY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-9566
Mailing Address - Country:US
Mailing Address - Phone:972-954-1469
Mailing Address - Fax:469-283-2743
Practice Address - Street 1:3140 LEGACY DR STE 310
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-9383
Practice Address - Country:US
Practice Address - Phone:972-435-4002
Practice Address - Fax:972-435-4105
Is Sole Proprietor?:No
Enumeration Date:2017-07-31
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133838363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily