Provider Demographics
NPI:1699463091
Name:GHOLSTON, SHERRI (FNP-C)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:GHOLSTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:2805 CLEARWATER TER SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-2485
Mailing Address - Country:US
Mailing Address - Phone:706-329-8007
Mailing Address - Fax:
Practice Address - Street 1:477 WINDSOR ST SW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2530
Practice Address - Country:US
Practice Address - Phone:404-688-9202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN189118363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily