Provider Demographics
NPI:1982691747
Name:BIEVER, SHERRI JO (FNP)
Entity Type:Individual
Prefix:MS
First Name:SHERRI
Middle Name:JO
Last Name:BIEVER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 N NILES AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-1924
Mailing Address - Country:US
Mailing Address - Phone:574-647-1610
Mailing Address - Fax:574-647-1825
Practice Address - Street 1:6913 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-8039
Practice Address - Country:US
Practice Address - Phone:574-647-4540
Practice Address - Fax:574-647-2567
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001638A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000383348OtherBCBS BMG MAIN ST
IN200473360Medicaid
IN178420SMedicare PIN
IN182870PMedicare PIN
IN178410NNMedicare PIN
IN200473360Medicaid
IN236040B6Medicare PIN