Provider Demographics
NPI:1720265341
Name:SHERROD, PRELINCA R (NP)
Entity type:Individual
Prefix:
First Name:PRELINCA
Middle Name:R
Last Name:SHERROD
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 31ST ST E STE A
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-2507
Mailing Address - Country:US
Mailing Address - Phone:205-331-4369
Mailing Address - Fax:205-331-4010
Practice Address - Street 1:907 31ST ST E STE A
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-2507
Practice Address - Country:US
Practice Address - Phone:205-331-4369
Practice Address - Fax:205-331-4010
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-25
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-068592363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-068592OtherALABAMA BOARD OF NURSING - NURSE PRACTITIONER LICENSE
AL3386699OtherAMERICAN NURSES CREDENTIALING CENTER- FNP CERTIFICATION