Provider Demographics
NPI:1992739866
Name:BRANDT, SHERRY JO (FNP)
Entity type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:JO
Last Name:BRANDT
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:148 TOWN AND COUNTRY DR
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-5433
Mailing Address - Country:US
Mailing Address - Phone:423-753-2308
Mailing Address - Fax:
Practice Address - Street 1:JAMES H. QUILLEN VAMC
Practice Address - Street 2:CORNER OF SIDNEY AND LAMONT
Practice Address - City:MOUNTAIN HOME
Practice Address - State:TN
Practice Address - Zip Code:37684
Practice Address - Country:US
Practice Address - Phone:423-926-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily