Provider Demographics
NPI:1063169480
Name:SHERMAN, KAYLA (FNP-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:571 NANCY LN
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-9521
Mailing Address - Country:US
Mailing Address - Phone:989-350-0902
Mailing Address - Fax:
Practice Address - Street 1:994 N CENTER AVE
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-9356
Practice Address - Country:US
Practice Address - Phone:989-732-3450
Practice Address - Fax:989-731-4513
Is Sole Proprietor?:No
Enumeration Date:2022-03-05
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704306835363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily