Provider Demographics
NPI:1295133676
Name:CORGAN, SHERRIE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SHERRIE
Middle Name:
Last Name:CORGAN
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 1:9330 PARK WEST BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4312
Mailing Address - Country:US
Mailing Address - Phone:865-690-3003
Mailing Address - Fax:865-690-6404
Practice Address - Street 1:9330 PARK WEST BLVD STE 402
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4312
Practice Address - Country:US
Practice Address - Phone:865-690-3003
Practice Address - Fax:865-690-6404
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000019275363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ013254Medicaid