Provider Demographics
NPI:1740666445
Name:SHERGILL, KIRBY MICHELLE (CRNA)
Entity type:Individual
Prefix:MRS
First Name:KIRBY
Middle Name:MICHELLE
Last Name:SHERGILL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:KIRBY
Other - Middle Name:MICHELLE
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:101 SURGEONS DR
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-5198
Mailing Address - Country:US
Mailing Address - Phone:843-236-6633
Mailing Address - Fax:
Practice Address - Street 1:101 SURGEONS DR
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-5198
Practice Address - Country:US
Practice Address - Phone:843-236-6633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19490367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered