Provider Demographics
NPI:1326385105
Name:RICHMOND, SHERRINE FAYE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SHERRINE
Middle Name:FAYE
Last Name:RICHMOND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:SHERRINE
Other - Middle Name:FAYE
Other - Last Name:PINNOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:917 RINEHART RD STE 2061
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-4878
Mailing Address - Country:US
Mailing Address - Phone:407-378-7976
Mailing Address - Fax:859-838-4413
Practice Address - Street 1:917 RINEHART RD STE 2061
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746
Practice Address - Country:US
Practice Address - Phone:407-378-7976
Practice Address - Fax:859-838-4413
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9213911363LF0000X, 363LW0102X
FLARNP 9213911363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023157300Medicaid