Provider Demographics
NPI:1598218737
Name:BAKLAND, SHERRI LEA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LEA
Last Name:BAKLAND
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MISS
Other - First Name:SHERRI
Other - Middle Name:LEA
Other - Last Name:EDGMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6130 SHALLOWFORD RD
Mailing Address - Street 2:STE 101
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7222
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:975 E 3RD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2147
Practice Address - Country:US
Practice Address - Phone:423-778-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-24
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNF06161918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily