Healthcare Provider Details

I. General information

NPI: 1770804239
Provider Name (Legal Business Name): SHERRI LEE SELLERS WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. SHERRI LEE PATTEN

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 03/08/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1692 CHATHAM PKWY
SAVANNAH GA
31405-1350
US

IV. Provider business mailing address

1692 CHATHAM PKWY
SAVANNAH GA
31405-1350
US

V. Phone/Fax

Practice location:
  • Phone: 912-629-6262
  • Fax: 912-226-3268
Mailing address:
  • Phone: 912-629-6262
  • Fax: 912-226-3268

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number53-77561-092
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number738335
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number2010024484
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number141039
License Number StateMO
# 5
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN290850
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: