Provider Demographics
NPI:1790191757
Name:OGLETREE, SHERRELL M (FNP)
Entity Type:Individual
Prefix:
First Name:SHERRELL
Middle Name:M
Last Name:OGLETREE
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 1:3515 RAYFORD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-4364
Mailing Address - Country:US
Mailing Address - Phone:281-350-7040
Mailing Address - Fax:
Practice Address - Street 1:3515 RAYFORD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-4364
Practice Address - Country:US
Practice Address - Phone:281-350-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-10
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP124530363LP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics