Sherry Bullard Jobe, RN, MSN, ACNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R701122 Issued in MS

Practice address

2668 S Harper Rd Ste 1
Corinth, MS 38834-6770

Phone

(662) 287-7138

Fax

(662) 287-7157

NPI assigned

Feb 17, 2010

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mrs. Sherry Bullard Wilson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409702400000",
    "number": "1609198753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORMAN RD",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349372",
            "telephone_number": "662-284-8566",
            "fax_number": "662-594-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2668 S HARPER RD STE 1",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388346770",
            "telephone_number": "662-287-7138",
            "fax_number": "662-287-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBE",
        "first_name": "SHERRY",
        "middle_name": "BULLARD",
        "name_prefix": "Mrs.",
        "credential": "RN, MSN, ACNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2014-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R701122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609198753",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHERRY",
            "last_name": "WILSON",
            "middle_name": "BULLARD",
            "prefix": "MRS.",
            "credential": "RN, MSN, ACNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James W. Cole, M.D.
• Madison Leggett James, NP
• Jessica Suzanne Jensen, MD
• Melina Paige Jetton, RN
• Brendan Jobe, HME PROVIDER
• Tina Marie Jobe, MD
• Joes Shoes
• John D Dodd
• John W. Prather, M.D.
• Amanda C Johnson, CRNA

• Adult Health Nurse Practitioner in Corinth, MS
• Providers in Corinth, MS by specialty
• Adult Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.