Provider Demographics
NPI:1760418305
Name:NASSAR, SHERRI L (FNP)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:L
Last Name:NASSAR
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 N 15TH AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3299
Mailing Address - Country:US
Mailing Address - Phone:406-585-3770
Mailing Address - Fax:
Practice Address - Street 1:1232 N 15TH AVE STE 1
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3299
Practice Address - Country:US
Practice Address - Phone:406-585-3770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT100496363LF0000X
MT28109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q33807Medicare UPIN