Provider Demographics
NPI:1730558677
Name:MCCAIN, SHERRI LATOSHA (FNP)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:LATOSHA
Last Name:MCCAIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7623 WILSON BLVD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-5722
Mailing Address - Country:US
Mailing Address - Phone:855-759-6647
Mailing Address - Fax:
Practice Address - Street 1:5816 SHAKESPEARE RD STE C
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-7233
Practice Address - Country:US
Practice Address - Phone:844-759-6647
Practice Address - Fax:803-741-5814
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19751363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP3575Medicaid
SCSC70375738Medicare PIN
SCNP3575Medicaid