Provider Demographics
NPI:1891737896
Name:RAY, SHERRY E (FNP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:E
Last Name:RAY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 GRAYSON DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3046
Mailing Address - Country:US
Mailing Address - Phone:615-352-6405
Mailing Address - Fax:615-792-9331
Practice Address - Street 1:342 FREY ST
Practice Address - Street 2:
Practice Address - City:ASHLAND CITY
Practice Address - State:TN
Practice Address - Zip Code:37015-1734
Practice Address - Country:US
Practice Address - Phone:615-792-1199
Practice Address - Fax:615-792-9331
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006944363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3905412Medicaid
TN3905412Medicaid
3905419Medicare ID - Type Unspecified