Provider Demographics
NPI:1407917982
Name:SHERRER, TRACY W (APRN)
Entity Type:Individual
Prefix:MS
First Name:TRACY
Middle Name:W
Last Name:SHERRER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:TRACY
Other - Middle Name:W
Other - Last Name:BRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 24387
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422-4387
Mailing Address - Country:US
Mailing Address - Phone:423-648-8480
Mailing Address - Fax:423-648-8481
Practice Address - Street 1:2000 STEIN DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7217
Practice Address - Country:US
Practice Address - Phone:423-648-8480
Practice Address - Fax:423-648-8481
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000089572363LA2200X
TNAPN0000006612363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP54018Medicare UPIN
TN3346329Medicare ID - Type Unspecified