Provider Demographics
NPI:1215069794
Name:CLARY, SHERI LYNN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:LYNN
Last Name:CLARY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9007 WHITFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ESTERO
Mailing Address - State:FL
Mailing Address - Zip Code:33928-4409
Mailing Address - Country:US
Mailing Address - Phone:239-992-1026
Mailing Address - Fax:239-992-7608
Practice Address - Street 1:17595 S TAMIAMI TRL
Practice Address - Street 2:SUITE #108
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-4570
Practice Address - Country:US
Practice Address - Phone:239-267-4788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3097363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical