Provider Demographics
NPI:1689952012
Name:GROGAN, SHERRY DEE (APRN, PMHNP)
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:DEE
Last Name:GROGAN
Suffix:
Gender:F
Credentials:APRN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7435 HIGHWAY 6 STE C
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-5135
Mailing Address - Country:US
Mailing Address - Phone:281-778-8715
Mailing Address - Fax:
Practice Address - Street 1:6140 HIGHWAY 6 STE 75
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-3802
Practice Address - Country:US
Practice Address - Phone:281-606-0622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-03
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX612230363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX288747302Medicaid
TX8047NFOtherBLUE CROSS BLUE SHIELD
TXP01363011OtherRR MEDICARE
TX1689952012OtherBLUE CROSS BLUE SHIELD
TX288747301Medicaid
TX1689952012OtherBLUE CROSS BLUE SHIELD
TXTXB139213Medicare PIN