Provider Demographics
NPI:1578386470
Name:HEDRICK, SIERRA
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:
Last Name:HEDRICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 OLD HICKORY BLVD UNIT 437
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5385
Mailing Address - Country:US
Mailing Address - Phone:606-367-1913
Mailing Address - Fax:
Practice Address - Street 1:615 OLD HICKORY BLVD UNIT 437
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-5385
Practice Address - Country:US
Practice Address - Phone:606-367-1913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant