Provider Demographics
NPI:1770867939
Name:LYTTON, SHERISHE (CNM)
Entity Type:Individual
Prefix:MRS
First Name:SHERISHE
Middle Name:
Last Name:LYTTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SHERISHE
Other - Middle Name:
Other - Last Name:SMARR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:1615
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2208
Mailing Address - Country:US
Mailing Address - Phone:404-230-5622
Mailing Address - Fax:404-230-5623
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:1615
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2208
Practice Address - Country:US
Practice Address - Phone:404-230-5622
Practice Address - Fax:404-230-5623
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN155251367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife