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NPI Code Detail

MEDICARE: SHERRYNE L CROSS RN

MEDICARE: SHERRYNE L CROSS RN
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
1163W00000XRegistered NurseRN147951GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN147951OTHERGALICENSE #

General Provider Information

NPI Number : 1730522855
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRYNE L CROSS RN
Provider Business Mailing Address
First Line : 2511 LANTRAC CT
Second Line :
City : DECATUR
State : GA
Zip : 30035-4006
Country : US
Telephone Number : 678-281-1554
Fax Number : 678-609-1484
Provider Business Practice Location Address
First Line : 2511 LANTRAC CT
Second Line :
City : DECATUR
State : GA
Zip : 30035-4006
Country : US
Telephone Number : 678-281-1554
Fax Number : 678-609-1484
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2013
Last Update Date : 04/08/2013

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