Healthcare Provider Details

I. General information

NPI: 1780486480
Provider Name (Legal Business Name): SHERRET REGISTER CBD, MSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 MONTGOMERY HWY STE 320
DOTHAN AL
36303-3299
US

IV. Provider business mailing address

112 ELMWOOD DR
DOTHAN AL
36303-5536
US

V. Phone/Fax

Practice location:
  • Phone: 662-614-4063
  • Fax:
Mailing address:
  • Phone: 662-614-4063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number1-194014
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: