MEDICARE: SHERRY HOLMAN REGISTERED NURSE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN114508	GA

General Provider Information

NPI Number	:	1669229373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY HOLMAN REGISTERED NURSE

Provider Business Mailing Address
First Line	:	2201 KIRKWOOD RD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31721-5206
Country	:	US
Telephone Number	:	229-889-1311
Fax Number	:

Provider Business Practice Location Address
First Line	:	2201 KIRKWOOD RD
Second Line	:
City	:	ALBANY
State	:	GA
Zip	:	31721-5206
Country	:	US
Telephone Number	:	229-889-1311
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2024
Last Update Date	:	05/01/2024

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