Provider Demographics
NPI:1700930054
Name:DOLL, SHERRI K (CNP)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:K
Last Name:DOLL
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:K
Other - Last Name:JACOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 E BROADWAY AVE
Mailing Address - Street 2:P.O. BOX 997
Mailing Address - City:BISMARCK
Mailing Address - State:ND
Mailing Address - Zip Code:58501-4520
Mailing Address - Country:US
Mailing Address - Phone:701-530-7000
Mailing Address - Fax:701-530-8842
Practice Address - Street 1:900 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58501-4520
Practice Address - Country:US
Practice Address - Phone:701-530-7000
Practice Address - Fax:701-530-8842
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR23751363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND500005981OtherRR MEDICARE
ND19564Medicaid
ND19564Medicaid
NDR02141Medicare UPIN