Provider Demographics
NPI:1922055896
Name:KINKADE, SHERRY (FNP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:KINKADE
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:PO BOX 762
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37111-0762
Mailing Address - Country:US
Mailing Address - Phone:931-273-3611
Mailing Address - Fax:
Practice Address - Street 1:7003 CHADWICK DR STE 350
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3260
Practice Address - Country:US
Practice Address - Phone:615-866-9623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN56061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4120650OtherBLUE CROSS
TNP00361932OtherMEDICARE RAILROAD
TN3906506Medicare PIN
TNP06020Medicare UPIN