Provider Demographics
NPI:1386376259
Name:AUGUSTINE, SHERMA U (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:SHERMA
Middle Name:U
Last Name:AUGUSTINE
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5914 WINNER AVE # B
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3815
Mailing Address - Country:US
Mailing Address - Phone:410-357-1497
Mailing Address - Fax:
Practice Address - Street 1:5914 WINNER AVE # B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3815
Practice Address - Country:US
Practice Address - Phone:410-357-1497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR129353363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty