Provider Demographics
NPI:1225282049
Name:SHERER, NICOLE M (ARNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:M
Last Name:SHERER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 PGA BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-2910
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-650-3455
Practice Address - Street 1:2893 ENTERPRISE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-2784
Practice Address - Country:US
Practice Address - Phone:386-789-8600
Practice Address - Fax:386-789-0219
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9436144363L00000X
IN71002790A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN232230VVVVMedicare UPIN
IN2480101Medicare UPIN
FLIS747ZMedicare PIN