Provider Demographics
NPI:1386604189
Name:SHERMAN, WANDA GAIL (FNPC)
Entity type:Individual
Prefix:MS
First Name:WANDA
Middle Name:GAIL
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:MS
Other - First Name:W
Other - Middle Name:GAIL
Other - Last Name:SHERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:275 JONES COVE RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-8700
Mailing Address - Country:US
Mailing Address - Phone:828-298-5106
Mailing Address - Fax:
Practice Address - Street 1:1100 TUNNEL RD
Practice Address - Street 2:PRIMARY CARE 3 VAMC
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28805-2043
Practice Address - Country:US
Practice Address - Phone:828-296-4442
Practice Address - Fax:828-299-5806
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200949363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC200949Medicare UPIN