Healthcare Provider Details

I. General information

NPI: 1285628834
Provider Name (Legal Business Name): SHERRIE JEANIENE DOSS DNP, WHNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2005
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2692 POPE RD
IVANHOE VA
24350-3614
US

IV. Provider business mailing address

2692 POPE RD
IVANHOE VA
24350-3614
US

V. Phone/Fax

Practice location:
  • Phone: 276-699-6341
  • Fax: 276-637-3041
Mailing address:
  • Phone: 276-699-6341
  • Fax: 276-637-3041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number0024166240
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024166240
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: