Provider Demographics
NPI:1013150010
Name:SHERICK, NICOLE CHRISTINE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:CHRISTINE
Last Name:SHERICK
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4718 WINTERDALE DR
Mailing Address - Street 2:
Mailing Address - City:PACE
Mailing Address - State:FL
Mailing Address - Zip Code:32571-1371
Mailing Address - Country:US
Mailing Address - Phone:630-308-0364
Mailing Address - Fax:
Practice Address - Street 1:10100 HILLVIEW DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514-5436
Practice Address - Country:US
Practice Address - Phone:850-478-5153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9648235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist