Healthcare Provider Details

I. General information

NPI: 1285405845
Provider Name (Legal Business Name): KADIE SHARRETT AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2024
Last Update Date: 01/12/2024
Certification Date: 01/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 STEELES RD
BRISTOL TN
37620-9532
US

IV. Provider business mailing address

502 TRAMMELL RD
BRISTOL TN
37620-5314
US

V. Phone/Fax

Practice location:
  • Phone: 423-217-1360
  • Fax: 423-217-1364
Mailing address:
  • Phone: 423-534-5874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1910
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1910
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: