Provider Demographics
NPI:1487142618
Name:PLASENCIA, SHERRI (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:PLASENCIA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 BRANDON RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6465
Mailing Address - Country:US
Mailing Address - Phone:863-286-1728
Mailing Address - Fax:
Practice Address - Street 1:1575 FLOWER DUST DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-5754
Practice Address - Country:US
Practice Address - Phone:813-729-2205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN244184163WE0003X
FL11040924363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WE0003XNursing Service ProvidersRegistered NurseEmergency