Provider Demographics
NPI:1851787253
Name:SHERWIN, KATHERINE GIORDANO (CRNA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:GIORDANO
Last Name:SHERWIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:RENEE
Other - Last Name:GIORDANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1080 OXFORD RD
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-2068
Mailing Address - Country:US
Mailing Address - Phone:586-604-2655
Mailing Address - Fax:952-442-3620
Practice Address - Street 1:3990 JOHN R ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201-2018
Practice Address - Country:US
Practice Address - Phone:313-745-7600
Practice Address - Fax:952-442-3620
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704309255367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered