Provider Demographics
NPI:1659651156
Name:MIKA, SHERYL (ICCE)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:
Last Name:MIKA
Suffix:
Gender:F
Credentials:ICCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 WESTGATE DR STE 504
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-2568
Mailing Address - Country:US
Mailing Address - Phone:919-618-9963
Mailing Address - Fax:
Practice Address - Street 1:3500 WESTGATE DR STE 504
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-2568
Practice Address - Country:US
Practice Address - Phone:919-618-9963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula