Provider Demographics
NPI:1548490816
Name:ROBERTS, SHERI NICOLE (CRNP)
Entity type:Individual
Prefix:
First Name:SHERI
Middle Name:NICOLE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 FRANKLIN ST SE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4312
Mailing Address - Country:US
Mailing Address - Phone:256-265-3012
Mailing Address - Fax:
Practice Address - Street 1:930 FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4312
Practice Address - Country:US
Practice Address - Phone:256-265-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100258363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL114953Medicaid
AL515-99963OtherBCBS
AL114951Medicaid
AL114952Medicaid
AL510-49752OtherBCBS
AL114950Medicaid
AL510-49750OtherBCBS
AL510-49751OtherBCBS
AL114948Medicaid
AL510-49753OtherBCBS
AL114952Medicaid