Healthcare Provider Details

I. General information

NPI: 1760202485
Provider Name (Legal Business Name): SHERRY THOMPSON-BENNETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2024
Last Update Date: 10/16/2024
Certification Date: 10/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 STATE ST STE A
NASHVILLE TN
37203-1869
US

IV. Provider business mailing address

2222 STATE ST STE A
NASHVILLE TN
37203-1869
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-2075
  • Fax:
Mailing address:
  • Phone: 615-327-2075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number28596
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: