Provider Demographics
NPI:1881852226
Name:BYGRAVES, SHERON ANGELA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SHERON
Middle Name:ANGELA
Last Name:BYGRAVES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6425 CANTON ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-5560
Mailing Address - Country:US
Mailing Address - Phone:727-865-0374
Mailing Address - Fax:
Practice Address - Street 1:6425 CANTON ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712-5560
Practice Address - Country:US
Practice Address - Phone:727-865-0374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-31
Last Update Date:2008-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5153429164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse