Provider Demographics
NPI:1932458122
Name:MISINCO, SHERRYL HEARN (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRYL
Middle Name:HEARN
Last Name:MISINCO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2958 SOUTHSHORE CT
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1168
Mailing Address - Country:US
Mailing Address - Phone:478-954-9213
Mailing Address - Fax:
Practice Address - Street 1:360 HOSPITAL DR
Practice Address - Street 2:BUILDING D SUITE 110
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31217-3874
Practice Address - Country:US
Practice Address - Phone:478-841-2707
Practice Address - Fax:478-841-2708
Is Sole Proprietor?:No
Enumeration Date:2012-09-03
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN168023363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily