Provider Demographics
NPI:1780141093
Name:RICHARDSON, SHERRIE B (APRN)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:B
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 608
Mailing Address - Street 2:
Mailing Address - City:MC CLELLANVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29458-0608
Mailing Address - Country:US
Mailing Address - Phone:843-990-7971
Mailing Address - Fax:843-887-3817
Practice Address - Street 1:675 N MORGAN AVE
Practice Address - Street 2:
Practice Address - City:ANDREWS
Practice Address - State:SC
Practice Address - Zip Code:29510-2417
Practice Address - Country:US
Practice Address - Phone:843-264-2680
Practice Address - Fax:843-264-2690
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22558363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily