Provider Demographics
NPI:1417467929
Name:SUER, SHERNETTE T (NP)
Entity Type:Individual
Prefix:
First Name:SHERNETTE
Middle Name:T
Last Name:SUER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHERNETTE
Other - Middle Name:
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:105 STEVENS AVE STE 506
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2683
Mailing Address - Country:US
Mailing Address - Phone:914-665-2229
Mailing Address - Fax:914-665-2228
Practice Address - Street 1:105 STEVENS AVE STE 506
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2683
Practice Address - Country:US
Practice Address - Phone:914-665-2229
Practice Address - Fax:914-665-2228
Is Sole Proprietor?:No
Enumeration Date:2017-10-10
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342343363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily