Provider Demographics
NPI:1124293741
Name:SHERK, CATHY JAN (CRNP)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:JAN
Last Name:SHERK
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 CHALYBE DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35226-6264
Mailing Address - Country:US
Mailing Address - Phone:205-941-1317
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY HOSPITAL RUSSELL
Practice Address - Street 2:1813 6TH AVE SOUTH
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-0001
Practice Address - Country:US
Practice Address - Phone:205-996-9260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-032241363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL$$$$$$$$$OtherSS