Provider Demographics
NPI:1790098796
Name:ATWOOD, SANDRA (APRN-BC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:ATWOOD
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 ESTATE ENIGHED
Mailing Address - Street 2:PMB 311
Mailing Address - City:ST JOHN
Mailing Address - State:VI
Mailing Address - Zip Code:00830-6120
Mailing Address - Country:US
Mailing Address - Phone:340-714-4270
Mailing Address - Fax:
Practice Address - Street 1:481-2 CHOCOLATE HOLE
Practice Address - Street 2:
Practice Address - City:ST JOHN
Practice Address - State:VI
Practice Address - Zip Code:00830-6120
Practice Address - Country:US
Practice Address - Phone:340-714-4270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VIAP11808P363LF0000X
MARN2262015163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse