Provider Demographics
NPI:1417611443
Name:PICKNEY, SHERELLE SION (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:SHERELLE
Middle Name:SION
Last Name:PICKNEY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1057
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-1057
Mailing Address - Country:US
Mailing Address - Phone:337-565-9320
Mailing Address - Fax:337-357-3980
Practice Address - Street 1:3419 NW EVANGELINE TRWY STE A-8
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-6241
Practice Address - Country:US
Practice Address - Phone:337-565-9320
Practice Address - Fax:337-357-3980
Is Sole Proprietor?:No
Enumeration Date:2021-10-26
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA221034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA863789609Medicaid