Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1801274618 |
---|---|
Provider Name | Derrick Sherrill |
First Address | La Vergne, TN 37086 |
Second Address | Antioch, TN 37013-4967 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2015 |
Last Update Date | 21/07/2021 |