Provider Demographics
NPI:1942671284
Name:SHERMAN, JEFFREY DIANNE
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:DIANNE
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 W STAN SCHLUETER LOOP
Mailing Address - Street 2:400A
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-4110
Mailing Address - Country:US
Mailing Address - Phone:254-702-2447
Mailing Address - Fax:
Practice Address - Street 1:2201 W STAN SCHLUETER LOOP
Practice Address - Street 2:400A
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-4110
Practice Address - Country:US
Practice Address - Phone:254-702-2447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment