MEDICARE: MS. SHERRIE IVORY CPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246RP1900X	Phlebotomy Technician	H2D6Z3R9	GA

General Provider Information

NPI Number	:	1992634919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHERRIE IVORY CPT

Provider Business Mailing Address
First Line	:	2465 RICHARDSON PKWY APT E330
Second Line	:
City	:	MORROW
State	:	GA
Zip	:	30260-3182
Country	:	US
Telephone Number	:	404-723-3543
Fax Number	:

Provider Business Practice Location Address
First Line	:	2465 RICHARDSON PKWY APT E330
Second Line	:
City	:	MORROW
State	:	GA
Zip	:	30260-3182
Country	:	US
Telephone Number	:	404-723-3543
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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