Provider Demographics
NPI:1225869779
Name:JOSEPH, SHERLY (APRN)
Entity type:Individual
Prefix:
First Name:SHERLY
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2178 TWISTED PINE RD FL 34861
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-7655
Mailing Address - Country:US
Mailing Address - Phone:321-437-5894
Mailing Address - Fax:
Practice Address - Street 1:2178 TWISTED PINE RD FL 34861
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-7655
Practice Address - Country:US
Practice Address - Phone:321-437-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLF07241264363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily