Provider Demographics
NPI:1932545878
Name:SHERR, NOVA DYLAN (RN)
Entity Type:Individual
Prefix:MISS
First Name:NOVA
Middle Name:DYLAN
Last Name:SHERR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 OLINVILLE AVE
Mailing Address - Street 2:APT 816
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-7611
Mailing Address - Country:US
Mailing Address - Phone:646-642-1072
Mailing Address - Fax:
Practice Address - Street 1:2440 OLINVILLE AVE
Practice Address - Street 2:APT 816
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-7611
Practice Address - Country:US
Practice Address - Phone:646-642-1072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY581707163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse