Provider Demographics
NPI:1720372733
Name:CULBERTSON, SHERRI
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:CULBERTSON
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 1:1190 US HWY 1 NORTH
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27596
Mailing Address - Country:US
Mailing Address - Phone:919-554-1183
Mailing Address - Fax:
Practice Address - Street 1:1190 US HWY 1 NORTH
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27596
Practice Address - Country:US
Practice Address - Phone:919-554-1183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13317183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist