Provider Demographics
NPI:1497928592
Name:CLUNAN, SHERI (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:CLUNAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-0001
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:1520 GAUSE BLVD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458
Practice Address - Country:US
Practice Address - Phone:985-646-0945
Practice Address - Fax:985-643-8510
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR859605363LF0000X
LAAP05622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00757391OtherRAILROAD MCARE THRU HCCN
MS03006042Medicaid
LA1343528Medicaid
LA1316124688OtherGROUP NPI
LA339164YYSMOtherMEDICARE GROUP PTAN
LA5DD16OtherMEDICARE PTAN
MS302I501472Medicare PIN