Provider Demographics
NPI:1821437120
Name:WHEELOCK, SHERRY L (RN,MS,ANP)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:L
Last Name:WHEELOCK
Suffix:
Gender:F
Credentials:RN,MS,ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 LAKEFRONT BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-4327
Mailing Address - Country:US
Mailing Address - Phone:716-849-8750
Mailing Address - Fax:716-849-8756
Practice Address - Street 1:50 LAKEFRONT BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-4327
Practice Address - Country:US
Practice Address - Phone:716-849-8750
Practice Address - Fax:716-849-8756
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-19
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306492363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health