Healthcare Provider Details

I. General information

NPI: 1134255086
Provider Name (Legal Business Name): KATHERINE COBLE SHEARON R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 10/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CORDELL HULL BUILDING FL 4 425 5TH AVENUE NORTH
NASHVILLE TN
37243-0001
US

IV. Provider business mailing address

109 IDLE DR
SHELBYVILLE TN
37160-5108
US

V. Phone/Fax

Practice location:
  • Phone: 615-532-2968
  • Fax: 615-532-2286
Mailing address:
  • Phone: 931-684-5961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN0000032397
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: