Healthcare Provider Details

I. General information

NPI: 1285711762
Provider Name (Legal Business Name): SHERRYL O DUNLAP FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 09/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 FRIO ST
CAMP WOOD TX
78833-0455
US

IV. Provider business mailing address

908 EVANS ST
UVALDE TX
78801-6051
US

V. Phone/Fax

Practice location:
  • Phone: 830-597-6424
  • Fax: 830-597-6427
Mailing address:
  • Phone: 830-278-5604
  • Fax: 830-279-0775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number890728
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: