Provider Demographics
NPI:1104465442
Name:FLETCHER, SHEREE
Entity type:Individual
Prefix:
First Name:SHEREE
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 BEAUCHAMP AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-3702
Mailing Address - Country:US
Mailing Address - Phone:469-427-5662
Mailing Address - Fax:
Practice Address - Street 1:3311 BEAUCHAMP AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-3702
Practice Address - Country:US
Practice Address - Phone:469-427-5662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide