Provider Demographics
NPI:1912302886
Name:SHERMAN, ROBERT JOHN JR (NP-C)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JOHN
Last Name:SHERMAN
Suffix:JR
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13217 RIVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39532-9240
Mailing Address - Country:US
Mailing Address - Phone:337-519-1034
Mailing Address - Fax:
Practice Address - Street 1:2222 SIMON BOLIVAR AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-1460
Practice Address - Country:US
Practice Address - Phone:504-444-7879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS903836363LF0000X
LA205105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily