Provider Demographics
NPI:1598916173
Name:SJERPS, MARY (ST)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:SJERPS
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CHUZZLEWIT DOWN
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7626
Mailing Address - Country:US
Mailing Address - Phone:615-333-1972
Mailing Address - Fax:
Practice Address - Street 1:4230 HARDING RD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-783-1260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist