Healthcare Provider Details

I. General information

NPI: 1023537099
Provider Name (Legal Business Name): SHERRI DIANE SHETLEY NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2017
Last Update Date: 11/03/2022
Certification Date: 11/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL DR
HENDERSONVILLE NC
28792-5272
US

IV. Provider business mailing address

412 LYNNE TERRY DR
THOMASVILLE NC
27360-9157
US

V. Phone/Fax

Practice location:
  • Phone: 855-774-5433
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number5009826
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number5009826
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: