Provider Demographics
NPI:1063864395
Name:ST.MARTIN, SHERRYL (DNP)
Entity Type:Individual
Prefix:
First Name:SHERRYL
Middle Name:
Last Name:ST.MARTIN
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 SUPERIOR DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1993
Mailing Address - Country:US
Mailing Address - Phone:507-288-8544
Mailing Address - Fax:507-288-8545
Practice Address - Street 1:3101 SUPERIOR DR NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1993
Practice Address - Country:US
Practice Address - Phone:507-288-8544
Practice Address - Fax:507-288-8545
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 4605364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health