Provider Demographics
NPI:1982927216
Name:MARTIN, SHERNET JACQUELINE (CRNA)
Entity type:Individual
Prefix:MS
First Name:SHERNET
Middle Name:JACQUELINE
Last Name:MARTIN
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:5784 WIDEWATERS PKWY
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13214-1890
Mailing Address - Country:US
Mailing Address - Phone:315-469-1130
Mailing Address - Fax:
Practice Address - Street 1:750 E ADAMS ST RM 4143
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2306
Practice Address - Country:US
Practice Address - Phone:315-464-4720
Practice Address - Fax:315-464-4905
Is Sole Proprietor?:No
Enumeration Date:2010-03-01
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC083633367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered