Provider Demographics
NPI:1326376682
Name:SHERWOOD, AMANDA M (APRN, FNP, BC)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:M
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:APRN, FNP, BC
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:M
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:227 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-1952
Mailing Address - Country:US
Mailing Address - Phone:636-931-2700
Mailing Address - Fax:
Practice Address - Street 1:227 MAIN ST
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-1952
Practice Address - Country:US
Practice Address - Phone:636-931-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-25
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009033462363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1720058381OtherJESSE DWAYNE HELTON NPI
MO1326376682Medicaid
MO595379306Medicaid
MO2009033462OtherLICENCE
MO595379314Medicaid
MO2009033462OtherLICENCE
MO1326376682Medicaid