Provider Demographics
NPI:1376625772
Name:DACY, SHERYL L (CRNA)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:L
Last Name:DACY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SHERYL
Other - Middle Name:L
Other - Last Name:ONEZINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:627 MILLRUN CT
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-7539
Mailing Address - Country:US
Mailing Address - Phone:478-319-0654
Mailing Address - Fax:770-251-8567
Practice Address - Street 1:840 PINE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2100
Practice Address - Country:US
Practice Address - Phone:478-745-4206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN098087367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA43ZCBTX166Medicare ID - Type Unspecified