Provider Demographics
NPI:1386968170
Name:WILLIAMS, SHERRY KAYE (NP)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:KAYE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 97
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35902-0097
Mailing Address - Country:US
Mailing Address - Phone:256-492-0131
Mailing Address - Fax:
Practice Address - Street 1:40745 HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:AL
Practice Address - Zip Code:36251-4807
Practice Address - Country:US
Practice Address - Phone:256-354-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-23
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-066193363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-53568OtherBLUE CROSS (CHEROKEE)
AL163859Medicaid