Healthcare Provider Details

I. General information

NPI: 1053331082
Provider Name (Legal Business Name): SHERRY L. SEXTON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 03/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 DESALES AVENUE
CHATTANOOGA TN
37404
US

IV. Provider business mailing address

725 GLENWOOD DRIVE SUTIE E-487
CHATTANOOGA TN
37404
US

V. Phone/Fax

Practice location:
  • Phone: 423-697-0014
  • Fax: 423-648-6280
Mailing address:
  • Phone: 423-697-0014
  • Fax: 423-648-6280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11727
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberAPN11727
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: