Provider Demographics
NPI:1063092195
Name:WARD, SHERRESSA LYNN
Entity type:Individual
Prefix:
First Name:SHERRESSA
Middle Name:LYNN
Last Name:WARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3223 DRAGONWICK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77045-3607
Mailing Address - Country:US
Mailing Address - Phone:832-892-4532
Mailing Address - Fax:
Practice Address - Street 1:2323 POLK ST APT 307
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77003-4407
Practice Address - Country:US
Practice Address - Phone:832-968-7175
Practice Address - Fax:713-583-8095
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1017610363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care