Provider Demographics
NPI:1043645047
Name:SHERMAN, ALICIA KAY (LPN)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:KAY
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 FORREST AVE
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-1026
Mailing Address - Country:US
Mailing Address - Phone:931-628-8129
Mailing Address - Fax:
Practice Address - Street 1:549 FORREST AVE
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-1026
Practice Address - Country:US
Practice Address - Phone:931-628-8129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN75555164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse