Healthcare Provider Details

I. General information

NPI: 1609787506
Provider Name (Legal Business Name): SHERITA MCPHERSON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 LAWYERS LN
COLUMBUS GA
31906-3129
US

IV. Provider business mailing address

919 LAWYERS LN
COLUMBUS GA
31906-3129
US

V. Phone/Fax

Practice location:
  • Phone: 706-256-3200
  • Fax:
Mailing address:
  • Phone: 706-256-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number2053437
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: