Basic Information
| Provider Information | |||||||||
| NPI: | 1932258571 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHERRILL | ||||||||
| FirstName: | CARLETTA | ||||||||
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| Credential: | RNFA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 116 WEYBRIDGE CIR APT C | ||||||||
| Address2: | |||||||||
| City: | ROYAL PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334111584 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617905957 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 116 WEYBRIDGE CIR APT C | ||||||||
| Address2: | |||||||||
| City: | ROYAL PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334111584 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5617905957 | ||||||||
| FaxNumber: | 7723352422 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/10/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WX0003X | 1878862 | FL | X | Nursing Service Providers | Registered Nurse | Obstetric, Inpatient | 363AS0400X | X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.