Provider Demographics
NPI:1285628115
Name:SHERRILL, RONALD NOLAN (DPH)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:NOLAN
Last Name:SHERRILL
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 MORRIS AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1527
Mailing Address - Country:US
Mailing Address - Phone:865-540-1002
Mailing Address - Fax:865-525-0522
Practice Address - Street 1:3218 MORRIS AVE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1527
Practice Address - Country:US
Practice Address - Phone:865-525-4886
Practice Address - Fax:865-525-5395
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-07
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC3909183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNC3909OtherPHARMACIST