Provider Demographics
NPI:1861436446
Name:WHITBY, SHERRY R (FNP)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:R
Last Name:WHITBY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:TRENTON
Mailing Address - State:TN
Mailing Address - Zip Code:38382-3321
Mailing Address - Country:US
Mailing Address - Phone:731-855-3510
Mailing Address - Fax:731-855-1387
Practice Address - Street 1:500 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-3321
Practice Address - Country:US
Practice Address - Phone:731-855-3510
Practice Address - Fax:731-855-1387
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN060730363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341584Medicaid
TN4030742OtherBLUECROSS
TN500024978OtherPTAN MEDICARE RAILROAD
TN3728972OtherPTAN
TN4030742OtherBLUECROSS