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General NPI Number Information
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NPI Number | 1013683911
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Entity Type | Individual
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Provider Name | MARY ELIZABETH SIMMONS-SHERLOCK APRN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2021
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Last Update Date | 04/17/2022
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Provider Practice Location Address
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Address Line | 210 ASHVILLE AVE
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City | CARY
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State | NC
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Zip | 27518-6600
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Country | US
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Telephone | 919-235-6460
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Fax |
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Provider Business Mailing Address
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Address Line | 109 PECKSKILL CT
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City | CARY
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State | NC
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Zip | 27519-8376
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Country | US
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Telephone | 516-554-1747
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5014802
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License Number State | NC
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