Healthcare Provider Details

I. General information

NPI: 1932022175
Provider Name (Legal Business Name): SHERLEY JEAN LOUIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DELILE TELFORT

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 REGENCY DR
HIRAM GA
30141-2004
US

IV. Provider business mailing address

57 REGENCY DR
HIRAM GA
30141-2004
US

V. Phone/Fax

Practice location:
  • Phone: 404-322-7049
  • Fax:
Mailing address:
  • Phone: 404-322-7049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number2133860616
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: