Provider Demographics
NPI:1598209553
Name:COUCH, SHERI HYDER
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:HYDER
Last Name:COUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1641
Mailing Address - Street 2:
Mailing Address - City:BRYSON CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28713-1641
Mailing Address - Country:US
Mailing Address - Phone:980-279-5801
Mailing Address - Fax:828-538-4441
Practice Address - Street 1:249 OAK ST
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:NC
Practice Address - Zip Code:28043-3585
Practice Address - Country:US
Practice Address - Phone:828-919-2393
Practice Address - Fax:888-284-2932
Is Sole Proprietor?:No
Enumeration Date:2016-12-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009150363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC19P4DOtherBCBS NC
NC1332003-0001OtherBWC
SCNP7963OtherSC MEDICAID
NC1598209553Medicaid
NCNCW841J277OtherMEDICARE
NCQ00164251OtherRAILROAD MEDICARE