Healthcare Provider Details

I. General information

NPI: 1871458133
Provider Name (Legal Business Name): SHERRY PATRICK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 QUEEN BEE DR
COLUMBIA TN
38401-1025
US

IV. Provider business mailing address

2531 QUEEN BEE DR
COLUMBIA TN
38401-1025
US

V. Phone/Fax

Practice location:
  • Phone: 407-458-4261
  • Fax:
Mailing address:
  • Phone: 407-458-4261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number40635
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: