Provider Demographics
NPI:1275602690
Name:WHITE, SHERRI GAYLE (NP)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:GAYLE
Last Name:WHITE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-952-2111
Mailing Address - Fax:423-282-1657
Practice Address - Street 1:311 PRINCETON RD
Practice Address - Street 2:SUITE 7
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2026
Practice Address - Country:US
Practice Address - Phone:423-282-3377
Practice Address - Fax:423-283-4746
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2024-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN115103363LA2100X
VA0024189829363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3346613Medicaid
P00419460OtherRAIL ROAD MEDICARE
TNTN0123OtherUNITED HEALTHCARE OF THE
TN4147062OtherBLUE CROSS OF TENNESSEE
P00419460OtherRAIL ROAD MEDICARE
TN3346613Medicaid
TN3346613Medicare PIN