Provider Demographics
NPI:1356003487
Name:PREVOST, SHERMA ANNITA (NP)
Entity Type:Individual
Prefix:
First Name:SHERMA
Middle Name:ANNITA
Last Name:PREVOST
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHERMA
Other - Middle Name:ANNITA
Other - Last Name:PREVOST
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:401 JOPLIN DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-8016
Mailing Address - Country:US
Mailing Address - Phone:214-334-7880
Mailing Address - Fax:
Practice Address - Street 1:401 JOPLIN DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-8016
Practice Address - Country:US
Practice Address - Phone:214-334-7880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1031417363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner