Provider Demographics
NPI:1689927485
Name:HOWARD, SHERRI ANNE (PA)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:ANNE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:ANNE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:5300 FAR HILLS AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2381
Mailing Address - Country:US
Mailing Address - Phone:937-433-7536
Mailing Address - Fax:
Practice Address - Street 1:2359 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BEXLEY
Practice Address - State:OH
Practice Address - Zip Code:43209-2421
Practice Address - Country:US
Practice Address - Phone:614-947-1716
Practice Address - Fax:614-947-1743
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-18
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50003593363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant