Provider Demographics
NPI:1427661271
Name:SHERMER, STACY (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:
Last Name:SHERMER
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13421 BALSAM LN N
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:MN
Mailing Address - Zip Code:55327-9740
Mailing Address - Country:US
Mailing Address - Phone:763-228-3522
Mailing Address - Fax:
Practice Address - Street 1:8600 114TH AVE N
Practice Address - Street 2:
Practice Address - City:CHAMPLIN
Practice Address - State:MN
Practice Address - Zip Code:55316-3869
Practice Address - Country:US
Practice Address - Phone:763-422-8706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-30
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist