Healthcare Provider Details

I. General information

NPI: 1386149730
Provider Name (Legal Business Name): SHERRI FRAZIER CROSBY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2018
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 12TH ST W
TIFTON GA
31794-3993
US

IV. Provider business mailing address

209 12TH ST W
TIFTON GA
31794-3993
US

V. Phone/Fax

Practice location:
  • Phone: 229-256-5226
  • Fax: 229-396-4912
Mailing address:
  • Phone: 229-326-9478
  • Fax: 229-396-4912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN188250
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: