Provider Demographics
NPI:1992104327
Name:SORRO, JENNIFER VAUGHN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:VAUGHN
Last Name:SORRO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 DOBBINS PIKE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:TN
Mailing Address - Zip Code:37148-5439
Mailing Address - Country:US
Mailing Address - Phone:615-258-3084
Mailing Address - Fax:
Practice Address - Street 1:585 NASHVILLE PIKE
Practice Address - Street 2:
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-3123
Practice Address - Country:US
Practice Address - Phone:615-451-4139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000038217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist