Provider Demographics
NPI:1962461376
Name:SUTHERLAND, ERRA JO (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:ERRA
Middle Name:JO
Last Name:SUTHERLAND
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2913
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-2913
Mailing Address - Country:US
Mailing Address - Phone:276-328-8000
Mailing Address - Fax:276-376-1020
Practice Address - Street 1:134 ROBERTS AVE SW
Practice Address - Street 2:
Practice Address - City:WISE
Practice Address - State:VA
Practice Address - Zip Code:24293-5800
Practice Address - Country:US
Practice Address - Phone:276-328-8000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024123472174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS96822Medicare UPIN