Provider Demographics
NPI:1184060089
Name:EAKIN, SHERRIE TILLEY (MSN, FNP-C)
Entity type:Individual
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First Name:SHERRIE
Middle Name:TILLEY
Last Name:EAKIN
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Gender:F
Credentials:MSN, FNP-C
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Mailing Address - Street 1:919 HIDDEN RDG
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3813
Mailing Address - Country:US
Mailing Address - Phone:469-282-2711
Mailing Address - Fax:469-282-2609
Practice Address - Street 1:401 DR MICHAEL DEBAKEY DR
Practice Address - Street 2:STE 100
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-5864
Practice Address - Country:US
Practice Address - Phone:337-436-6100
Practice Address - Fax:337-436-6190
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2016-11-02
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Provider Licenses
StateLicense IDTaxonomies
LAAP07284363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2354442Medicaid
LA2354442Medicaid