Provider Demographics
NPI:1275519266
Name:BILBO, SHERRY L (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:L
Last Name:BILBO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:SHERRY
Other - Middle Name:L
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:801 N WEISGARBER RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-2706
Mailing Address - Country:US
Mailing Address - Phone:865-588-5121
Mailing Address - Fax:
Practice Address - Street 1:801 N WEISGARBER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2706
Practice Address - Country:US
Practice Address - Phone:865-588-5121
Practice Address - Fax:865-588-2126
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0442363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNR08840Medicare UPIN
TN3666224Medicare ID - Type Unspecified