Provider Demographics
NPI:1629319363
Name:SHERRICK, JENNIFER DAWN (NP-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DAWN
Last Name:SHERRICK
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10730 NALL AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1366
Mailing Address - Country:US
Mailing Address - Phone:916-375-4280
Mailing Address - Fax:816-276-3790
Practice Address - Street 1:10730 NALL AVE
Practice Address - Street 2:STE 101
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1366
Practice Address - Country:US
Practice Address - Phone:916-375-4280
Practice Address - Fax:816-276-3790
Is Sole Proprietor?:No
Enumeration Date:2013-03-05
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013004414363LA2200X
KS150848363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health