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General NPI Number Information
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NPI Number | 1548341175
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Entity Type | Individual
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Provider Name | SHERRY RAY APN
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Gender | Female
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 08/29/2016
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Provider Practice Location Address
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Address Line | 615 DERBY ST
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1632
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Country | US
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Telephone | 423-493-2905
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Fax | 423-493-2950
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Provider Business Mailing Address
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Address Line | 615 DERBY ST
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1632
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Country | US
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Telephone | 423-493-2905
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Fax | 423-493-2950
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN0000006614
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN0000089686
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License Number State | TN
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