Provider Demographics
NPI:1437398963
Name:WILSON, SHERYL ANN (CRNP)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:ANN
Last Name:WILSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 GREAT PINE RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-2819
Mailing Address - Country:US
Mailing Address - Phone:205-854-2772
Mailing Address - Fax:205-854-5284
Practice Address - Street 1:1608 GREAT PINE RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-2819
Practice Address - Country:US
Practice Address - Phone:205-854-2772
Practice Address - Fax:205-854-5284
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1030864363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal