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NPI 1326532003

NPI 1326532003 : SHERYL D NEWCOMB NP-C : SOUTH BOSTON, VA

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General NPI Number Information
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    NPI Number           |    1326532003
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    Entity Type          |    Individual 
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    Provider Name        |    SHERYL D NEWCOMB NP-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/18/2018
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    Last Update Date     |    06/18/2018
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Provider Practice Location Address
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    Address Line         |    2232 WILBORN AVE STE A 
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    City                 |    SOUTH BOSTON
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    State                |    VA
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    Zip                  |    24592-1662
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    Country              |    US
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    Telephone            |    434-572-8977
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2232 WILBORN AVE STE A 
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    City                 |    SOUTH BOSTON
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    State                |    VA
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    Zip                  |    24592-1662
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    Country              |    US
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    Telephone            |    434-572-8977
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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        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    0024176203
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    License Number State |    VA
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