Provider Demographics
NPI:1003305780
Name:SHERWOOD, REBECCA JENKINS (CRNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:JENKINS
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:REBECCA
Other - Middle Name:JENKINS
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:97 MARTIN LUTHER KING JR DR
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029-1648
Mailing Address - Country:US
Mailing Address - Phone:478-957-9139
Mailing Address - Fax:
Practice Address - Street 1:97 MARTIN LUTHER KING JR DR
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-1648
Practice Address - Country:US
Practice Address - Phone:478-957-9139
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2025-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN223109363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily