Provider Demographics
NPI:1801972880
Name:SHERMAN, TERRI DIANE (APRN-FNP-C)
Entity type:Individual
Prefix:MS
First Name:TERRI
Middle Name:DIANE
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:APRN-FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3630
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86003-3630
Mailing Address - Country:US
Mailing Address - Phone:928-522-9400
Mailing Address - Fax:928-774-6687
Practice Address - Street 1:301 S 7TH ST
Practice Address - Street 2:
Practice Address - City:WILLIAMS
Practice Address - State:AZ
Practice Address - Zip Code:86046-2324
Practice Address - Country:US
Practice Address - Phone:928-635-4441
Practice Address - Fax:928-635-4403
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR46608363LF0000X
AZAP2633363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ774407Medicaid
AZ3358206Medicare ID - Type Unspecified
AZ774407Medicaid