Provider Demographics
NPI:1922771518
Name:RIDGE, SHERI LYNN (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHERI
Middle Name:LYNN
Last Name:RIDGE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 HIGHWAY 28
Mailing Address - Street 2:STE 100
Mailing Address - City:JASPER
Mailing Address - State:TN
Mailing Address - Zip Code:37347-3696
Mailing Address - Country:US
Mailing Address - Phone:423-939-1500
Mailing Address - Fax:423-939-1503
Practice Address - Street 1:980 HIGHWAY 28 STE 100
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TN
Practice Address - Zip Code:37347-3696
Practice Address - Country:US
Practice Address - Phone:423-939-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30042363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner