Provider Demographics
NPI:1285628834
Name:DOSS, SHERRIE JEANIENE (DNP, WHNP, CNM)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:JEANIENE
Last Name:DOSS
Suffix:
Gender:F
Credentials:DNP, WHNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2692 POPE RD
Mailing Address - Street 2:
Mailing Address - City:IVANHOE
Mailing Address - State:VA
Mailing Address - Zip Code:24350-3614
Mailing Address - Country:US
Mailing Address - Phone:276-699-6341
Mailing Address - Fax:276-637-3041
Practice Address - Street 1:2692 POPE RD
Practice Address - Street 2:
Practice Address - City:IVANHOE
Practice Address - State:VA
Practice Address - Zip Code:24350-3614
Practice Address - Country:US
Practice Address - Phone:276-699-6341
Practice Address - Fax:276-637-3041
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-08
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166240367A00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1285628834Medicaid
VA017999C18Medicare PIN
VA1285628834Medicaid
VA012767C07Medicare PIN
VAP00372736Medicare PIN
012767C07Medicare PIN