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General NPI Number Information
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NPI Number | 1649736653
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Entity Type | Individual
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Provider Name | SHERRIE GRAY CASS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/14/2019
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 5130 SOUTHPORT SUPPLY RD SE STE 101-2
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City | SOUTHPORT
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State | NC
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Zip | 28461-9261
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Country | US
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Telephone | 910-477-9038
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Fax |
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Provider Business Mailing Address
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Address Line | 103 BONNETTS CREEK LN
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City | SOUTHPORT
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State | NC
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Zip | 28461-3150
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Country | US
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Telephone | 919-605-4901
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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 | 5011461
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License Number State | NC
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