Provider Demographics
NPI:1306271168
Name:SHERMAN, DEON (LPN)
Entity type:Individual
Prefix:
First Name:DEON
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4918 70TH PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1634
Mailing Address - Country:US
Mailing Address - Phone:216-316-3099
Mailing Address - Fax:
Practice Address - Street 1:4918 70TH PL
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1634
Practice Address - Country:US
Practice Address - Phone:216-316-3099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-11
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP50956164W00000X
OH153060164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse