Healthcare Provider Details

I. General information

NPI: 1376625772
Provider Name (Legal Business Name): SHERYL L DACY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 CASTLE POINT RD
WAPPINGERS FALLS NY
12590-7125
US

IV. Provider business mailing address

627 MILLRUN CT
MACON GA
31210-7539
US

V. Phone/Fax

Practice location:
  • Phone: 845-831-2000
  • Fax:
Mailing address:
  • Phone: 478-319-0654
  • Fax: 770-251-8567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN098087
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: