Provider Demographics
NPI:1497357669
Name:PHILIP, SHERRY AJU (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:AJU
Last Name:PHILIP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:SHERRY
Other - Middle Name:ANNA
Other - Last Name:VARGHESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14690 SPRING HILL DR STE 305
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:401 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34453-3838
Practice Address - Country:US
Practice Address - Phone:352-419-6526
Practice Address - Fax:352-419-8966
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1204713363L00000X
FLAPRN11012690363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner