Healthcare Provider Details

I. General information

NPI: 1861436446
Provider Name (Legal Business Name): SHERRY R WHITBY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 12/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 HOSPITAL DR
TRENTON TN
38382-3321
US

IV. Provider business mailing address

500 HOSPITAL DR
TRENTON TN
38382-3321
US

V. Phone/Fax

Practice location:
  • Phone: 731-855-3510
  • Fax: 731-855-1387
Mailing address:
  • Phone: 731-855-3510
  • Fax: 731-855-1387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number060730
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: