Provider Demographics
NPI:1013253590
Name:SHERMAN, SHANNA ANN (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:ANN
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:SHANNA
Other - Middle Name:ANN
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2901 58TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-1326
Mailing Address - Country:US
Mailing Address - Phone:727-822-4300
Mailing Address - Fax:727-456-1399
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:SUITE 605
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-822-4300
Practice Address - Fax:727-456-1399
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2015-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9258728363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL007950100Medicaid