Provider Demographics
NPI:1194453829
Name:CAUDILL, SHERRI DIANE (FNP)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:DIANE
Last Name:CAUDILL
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 1:5529 50TH ST APT 1806
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-1657
Mailing Address - Country:US
Mailing Address - Phone:806-642-3442
Mailing Address - Fax:
Practice Address - Street 1:4102 22ND PL
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1122
Practice Address - Country:US
Practice Address - Phone:806-725-0237
Practice Address - Fax:806-725-1030
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1088566363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily