Provider Demographics
NPI:1215181052
Name:ELY, SHERIDAN LOUISE (RN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERIDAN
Middle Name:LOUISE
Last Name:ELY
Suffix:
Gender:F
Credentials:RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2
Mailing Address - Street 2:708 CEDAR ST
Mailing Address - City:HEARNE
Mailing Address - State:TX
Mailing Address - Zip Code:77859-0002
Mailing Address - Country:US
Mailing Address - Phone:979-279-3940
Mailing Address - Fax:
Practice Address - Street 1:505 MAXEY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77013-5072
Practice Address - Country:US
Practice Address - Phone:713-681-3599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX223793363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily