Provider Demographics
NPI:1194919274
Name:SHERARD, MATTIE YULONDA (NP-C)
Entity type:Individual
Prefix:MRS
First Name:MATTIE
Middle Name:YULONDA
Last Name:SHERARD
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3204 MILLBROOK DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35810-3235
Mailing Address - Country:US
Mailing Address - Phone:423-400-3056
Mailing Address - Fax:
Practice Address - Street 1:6231 PERIMETER DR STE 113
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3658
Practice Address - Country:US
Practice Address - Phone:423-475-5088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000012272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily