Provider Demographics
NPI:1306848874
Name:WARD, SHERRY T (APRN)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:T
Last Name:WARD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:SHERRY
Other - Middle Name:TILLMAN
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP, APRN
Mailing Address - Street 1:PO BOX 6984
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32550-1018
Mailing Address - Country:US
Mailing Address - Phone:850-837-0769
Mailing Address - Fax:
Practice Address - Street 1:12598 EMERALD COAST PKWY W UNIT 101
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-2102
Practice Address - Country:US
Practice Address - Phone:850-654-8878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-13
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN073715 NP363LF0000X
FLARNP 2714622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP57072Medicare UPIN