Provider Demographics
NPI:1417208711
Name:SHERWOOD, NANCY RUTH (BA, IBCLC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:RUTH
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:BA, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1592 STOWE ROAD
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20194-1601
Mailing Address - Country:US
Mailing Address - Phone:703-834-3831
Mailing Address - Fax:
Practice Address - Street 1:1592 STOWE RD
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20194-1601
Practice Address - Country:US
Practice Address - Phone:703-834-3831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-26
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN