Missildine, Sherry Lynn

Missildine, Sherry Lynn is an individual health care provider with primary practice located at 2602 Saint Michael Dr Ste 302B , Texarkana TX 75503-5228. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Missildine, Sherry Lynn can be contacted via phone (903) 614-5180.

Contact Information

Primary practice address
2602 Saint Michael Dr Ste 302B Texarkana TX 75503-5228
Phone: (903) 614-5180
Fax: (903) 614-5169
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 704242 Texas
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP115139 Texas
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 658 Colorado

Profile Details

NPI number 1215952965
LBN Legal business name Missildine, Sherry Lynn
Credentials RN, MSN, ACNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2006
Last updated Sep 27th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215952965 NPPES
Texas Other 1F7305 MCR PIN - CTC
Texas MEDICAID 197789401 MCR PIN - CTC
Texas Other 8Y8806 MCR PIN - CTC
Texas MEDICAID 200223530A MCR PIN - CTC

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