Provider Demographics
NPI:1831784164
Name:WHEELER, SHERWANNA MELISSA (CRNP)
Entity type:Individual
Prefix:MS
First Name:SHERWANNA
Middle Name:MELISSA
Last Name:WHEELER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 740015
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0015
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7028 HIGHWAY 85
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2946
Practice Address - Country:US
Practice Address - Phone:470-444-3136
Practice Address - Fax:470-298-7730
Is Sole Proprietor?:No
Enumeration Date:2021-03-09
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-0991822207Q00000X
AL1-091822363LF0000X
GAGAA-NP000979363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine