Provider Demographics
NPI:1700337458
Name:BORCHARDT, SHERI ANNE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:ANNE
Last Name:BORCHARDT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:SHERI
Other - Middle Name:ANNE
Other - Last Name:DANIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1289 SW STATE ROAD 47
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32025-0484
Mailing Address - Country:US
Mailing Address - Phone:386-755-0421
Mailing Address - Fax:
Practice Address - Street 1:1289 SW STATE ROAD 47
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32025-0484
Practice Address - Country:US
Practice Address - Phone:386-755-0421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-18
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9294178363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily