Healthcare Provider Details

I. General information

NPI: 1437510484
Provider Name (Legal Business Name): SHERRIE BERRY APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2016
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 E G ST
ELIZABETHTON TN
37643-3288
US

IV. Provider business mailing address

1543 VALLEY DR
BRISTOL TN
37620-5154
US

V. Phone/Fax

Practice location:
  • Phone: 423-543-2521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20966
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: