Provider Demographics
NPI:1730474925
Name:HERMES, SHARONA LEE
Entity Type:Individual
Prefix:
First Name:SHARONA
Middle Name:LEE
Last Name:HERMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHARONA
Other - Middle Name:LEE
Other - Last Name:SCHROEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271 57TH PL NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-5423
Mailing Address - Country:US
Mailing Address - Phone:612-600-8700
Mailing Address - Fax:
Practice Address - Street 1:271 57TH PL NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-5423
Practice Address - Country:US
Practice Address - Phone:612-600-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8195225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist