Provider Demographics
NPI:1861619033
Name:MYERS, SHERIE D (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHERIE
Middle Name:D
Last Name:MYERS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1023 MCCALLA ST NE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012-4523
Mailing Address - Country:US
Mailing Address - Phone:770-784-8474
Mailing Address - Fax:770-784-8473
Practice Address - Street 1:100 HAMILL ST
Practice Address - Street 2:OXFORD COLLEGE STUDENT HEALTH SERVICE
Practice Address - City:OXFORD
Practice Address - State:GA
Practice Address - Zip Code:30054-2291
Practice Address - Country:US
Practice Address - Phone:770-784-8474
Practice Address - Fax:770-784-8473
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN145952 NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA50BBDCJMedicare ID - Type Unspecified