Healthcare Provider Details

I. General information

NPI: 1700206323
Provider Name (Legal Business Name): SHERRI MARCUS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2014
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 HIGHWAY 11 E
BULLS GAP TN
37711-3417
US

IV. Provider business mailing address

275 HIGHWAY 11 E
BULLS GAP TN
37711-3417
US

V. Phone/Fax

Practice location:
  • Phone: 423-393-4052
  • Fax:
Mailing address:
  • Phone: 423-393-4052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000037404
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN0000141105
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: