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General NPI Number Information
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NPI Number | 1003578840
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Entity Type | Individual
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Provider Name | MRS. SHERLY JOHN
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Gender | Female
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Dates
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Enumeration Date | 10/08/2021
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 715 PEACHTREE STREET SUITE 100-200 OFFICE 2045-2047
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City | ATLANTA
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State | GA
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Zip | 30308
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Country | US
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Telephone | 248-824-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 432 HINTON FARM WAY
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City | DACULA
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State | GA
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Zip | 30019-2175
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Country | US
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Telephone | 248-824-6400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AG08210123
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License Number State | GA
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