Healthcare Provider Details

I. General information

NPI: 1477232007
Provider Name (Legal Business Name): SIERRA DORRIS BRIDGERS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIERRA DORRIS TODD APRN

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 07/12/2023
Certification Date: 07/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 JONES ST
SPRINGFIELD TN
37172-3718
US

IV. Provider business mailing address

128 GREYSTONE DR
SPRINGFIELD TN
37172-5027
US

V. Phone/Fax

Practice location:
  • Phone: 615-433-8201
  • Fax:
Mailing address:
  • Phone: 615-719-0348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number34219
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: