Provider Demographics
NPI:1639345432
Name:SHERRILL, MICHELE STCLAIR (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:STCLAIR
Last Name:SHERRILL
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1605 CURTIS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28697-2231
Mailing Address - Country:US
Mailing Address - Phone:336-658-5691
Mailing Address - Fax:336-658-5694
Practice Address - Street 1:1605 CURTIS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-2231
Practice Address - Country:US
Practice Address - Phone:336-658-5691
Practice Address - Fax:336-658-5694
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7004293Medicaid
NC71-0941094OtherHEALTHWORKS MEDICAL GROUP OF NORTH CAROLINA PC
NC2593541OtherMEDICARE PTAN