Provider Demographics
NPI:1730143710
Name:SHERMAN, TRACY (CRNA)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N DUKE ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2250
Mailing Address - Country:US
Mailing Address - Phone:717-544-5511
Mailing Address - Fax:
Practice Address - Street 1:169 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1734
Practice Address - Country:US
Practice Address - Phone:717-733-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN286256L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA430073314OtherRR MEDICARE
PA001385594OtherHIGHMARK
PA3372007OtherAETNA-HMO
PA7141503OtherAETNA-NON HMO
PA50055803OtherCAPITAL BLUE CROSS
PA50055803OtherKEYSTONE HEALTH PLAN CENTRAL
PA2075631000OtherINDEPENDENCE BLUE CROSS
PA72306OtherGEISINGER
PA056951Medicare ID - Type Unspecified