Provider Demographics
NPI:1841482197
Name:CHRESTMAN, SHERRY B (FNP-C)
Entity type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:B
Last Name:CHRESTMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1970 GRANDVIEW DR
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-5066
Mailing Address - Country:US
Mailing Address - Phone:662-227-3700
Mailing Address - Fax:662-227-3740
Practice Address - Street 1:1970 GRANDVIEW DR
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-5066
Practice Address - Country:US
Practice Address - Phone:662-227-3700
Practice Address - Fax:662-227-3740
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR742975363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner