Provider Demographics
NPI:1114278884
Name:GILL, SHERRY E (CNP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:E
Last Name:GILL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:E
Other - Last Name:GILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNS
Mailing Address - Street 1:1410 ASPEN DR
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4887
Mailing Address - Country:US
Mailing Address - Phone:575-437-7000
Mailing Address - Fax:
Practice Address - Street 1:1410 ASPEN DR
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4887
Practice Address - Country:US
Practice Address - Phone:575-437-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2017-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNS-00239364SA2200X
NMCNP-03193363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health