Provider Demographics
NPI:1013683911
Name:SIMMONS-SHERLOCK, MARY ELIZABETH (APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ELIZABETH
Last Name:SIMMONS-SHERLOCK
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MRS
Other - First Name:MARY LIZ
Other - Middle Name:
Other - Last Name:SIMMONS-SHERLOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:109 PECKSKILL CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8376
Mailing Address - Country:US
Mailing Address - Phone:516-554-1747
Mailing Address - Fax:
Practice Address - Street 1:210 ASHVILLE AVE
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-6600
Practice Address - Country:US
Practice Address - Phone:919-235-6460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5014802363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily