Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 9022 | NC |
N | 122300000X | Dentist | DEN03051 | RI |
N | 1223D0001X | Dental Public Health | 9022 | NC |
Y | 1223G0001X | General Practice | 9022 | NC |
Y | 213EG0000X | General Practice | 9022 | NC |
NPI | 1568692382 |
---|---|
Provider Name | Angella Mae Sherrill |
First Address | Clinton, NC 28328-0410 |
Second Address | Clinton, NC 28328-0410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2009 |
Last Update Date | 21/06/2013 |