Healthcare Provider Details

I. General information

NPI: 1194077875
Provider Name (Legal Business Name): SHEBA DRYER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2012
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 REDMOND RD NW
ROME GA
30165-1416
US

IV. Provider business mailing address

1825 MARTHA BERRY BLVD NW
ROME GA
30165-1625
US

V. Phone/Fax

Practice location:
  • Phone: 706-233-8514
  • Fax: 706-233-8515
Mailing address:
  • Phone: 706-295-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1004077
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-082574
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN137657
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: