Provider Demographics
NPI:1144928367
Name:GAMMON, SHARLEEN (NP)
Entity type:Individual
Prefix:
First Name:SHARLEEN
Middle Name:
Last Name:GAMMON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 3RD ST STE B
Mailing Address - Street 2:
Mailing Address - City:FARWELL
Mailing Address - State:TX
Mailing Address - Zip Code:79325-4669
Mailing Address - Country:US
Mailing Address - Phone:806-481-7000
Mailing Address - Fax:806-481-1006
Practice Address - Street 1:405 AVENUE A
Practice Address - Street 2:
Practice Address - City:FARWELL
Practice Address - State:TX
Practice Address - Zip Code:79325-6657
Practice Address - Country:US
Practice Address - Phone:806-481-7000
Practice Address - Fax:806-481-1006
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1110549363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily