Provider Demographics
NPI:1225547185
Name:SAINT, SHEREDA J (NP-C)
Entity Type:Individual
Prefix:
First Name:SHEREDA
Middle Name:J
Last Name:SAINT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SHEREDA
Other - Middle Name:J
Other - Last Name:JUSTICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RIENZI
Mailing Address - State:MS
Mailing Address - Zip Code:38865-9500
Mailing Address - Country:US
Mailing Address - Phone:662-415-3459
Mailing Address - Fax:
Practice Address - Street 1:1331 CITY AVE N
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:MS
Practice Address - Zip Code:38663-1102
Practice Address - Country:US
Practice Address - Phone:662-993-9336
Practice Address - Fax:662-993-9338
Is Sole Proprietor?:No
Enumeration Date:2017-09-22
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS902333363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily