Doctor Name: | J. ELAINE SHERRILL |
NPI Number: | 1346684594 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | A003842 |
Business Practice Address: | 2251 Bill Foster Memorial Hwy Ste B Cabot, AR - 720237200 |
Business Phone Number: | 5019413345 |
Business Fax Number: | 5019413340 |
Mailing Address: | 19 Louisiana Downs Cv, SCOTT |
State: | AR |
Postal Code: | 721429719 |
Phone Number: | 5019444354 |
Fax Number: | |
NPI Enumeration Date: | 04/18/2013 |
NPI Last Update Date: | 11/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | A003842 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |