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General NPI Number Information
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NPI Number | 1326899295
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Entity Type | Individual
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Provider Name | SHERRY JOHNSON CRANIAL PROSTHETIC
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 214 NOTTINGHAM DR STE 303
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City | CARY
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State | NC
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Zip | 27511-4915
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Country | US
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Telephone | 919-227-6848
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37221
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City | RALEIGH
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State | NC
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Zip | 27627-7221
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Country | US
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Telephone | 919-227-6848
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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 | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | FTTXCRD1DA
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License Number State | NC
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