Provider Demographics
NPI:1497976781
Name:COPELAND, SHERRYL C (APRN)
Entity Type:Individual
Prefix:
First Name:SHERRYL
Middle Name:C
Last Name:COPELAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:C
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:APRN
Mailing Address - Street 1:1350 PINE LEVEL CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:GA
Mailing Address - Zip Code:31510-5604
Mailing Address - Country:US
Mailing Address - Phone:912-632-7775
Mailing Address - Fax:912-367-5516
Practice Address - Street 1:209 S TALLAHASSEE ST
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:GA
Practice Address - Zip Code:31539-6025
Practice Address - Country:US
Practice Address - Phone:912-375-3095
Practice Address - Fax:912-375-0064
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN066094363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily