Provider Demographics
NPI:1043833478
Name:SHERMAN, JUSTINE ROBERTA LEE (NP)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:ROBERTA LEE
Last Name:SHERMAN
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 1:7641 N UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3863
Mailing Address - Country:US
Mailing Address - Phone:719-494-3948
Mailing Address - Fax:949-695-4411
Practice Address - Street 1:USAF 4102 PINION DRIVE
Practice Address - Street 2:
Practice Address - City:USAF ACADEMY
Practice Address - State:CO
Practice Address - Zip Code:80840-2540
Practice Address - Country:US
Practice Address - Phone:719-439-9661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-20
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0995522-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily