Provider Demographics
NPI:1548234172
Name:BRAMBLETT, SHERRY MARIE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:MARIE
Last Name:BRAMBLETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 OAK ST
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-2085
Mailing Address - Country:US
Mailing Address - Phone:850-926-0400
Mailing Address - Fax:850-926-1938
Practice Address - Street 1:48 OAK ST
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-2085
Practice Address - Country:US
Practice Address - Phone:850-926-3591
Practice Address - Fax:850-926-2178
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2934712363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL300773100Medicaid