Provider Demographics
NPI:1104648864
Name:SHERMAN, JESSICA R (AGPCNP-BC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:R
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 SHERMAN DR
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:VT
Mailing Address - Zip Code:05676-9835
Mailing Address - Country:US
Mailing Address - Phone:802-777-3111
Mailing Address - Fax:
Practice Address - Street 1:142 WOODRIDGE RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:VT
Practice Address - Zip Code:05602-9165
Practice Address - Country:US
Practice Address - Phone:802-371-4712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2025-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101.0137481363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health