Most Relevant Information
Provider Data
| NPI Number: | 1003578840 |
| Provider Name: | SHERLY JOHN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2200X |
| Specialty: | Nurse Practitioner |
| License Number: | AG08210123 |
Most Important Dates
| Enumeration Date: | 10/08/2021 |
| Last Updated: | 10/13/2021 |
Provider Practice Location
4958 MEMORIAL DR
STONE MOUNTAIN
GA
300834148
Practice Location Phone/Fax
| Phone: | 4048092408 |
| Fax: |
Provider Mailing Location
432 HINTON FARM WAY
DACULA
GA
300192175
Provider Mailing Phone/Fax
| Phone: | 6788006651 |
| Fax: |