Provider Demographics
NPI:1952560047
Name:HOLEMON, SHERI (PAC)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:
Last Name:HOLEMON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18700 N 64TH DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7109
Mailing Address - Country:US
Mailing Address - Phone:623-561-5437
Mailing Address - Fax:623-561-9320
Practice Address - Street 1:18700 N 64TH DR
Practice Address - Street 2:SUITE 301
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-7109
Practice Address - Country:US
Practice Address - Phone:623-561-5437
Practice Address - Fax:623-561-9320
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ3336363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant