Provider Demographics
NPI:1134193709
Name:SHERWOOD, PAMELA L (ARNP)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:L
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8607 EASTHAVEN CT STE 101
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-5217
Mailing Address - Country:US
Mailing Address - Phone:727-669-6800
Mailing Address - Fax:727-669-2540
Practice Address - Street 1:8607 EASTHAVEN CT STE 101
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5217
Practice Address - Country:US
Practice Address - Phone:727-669-6800
Practice Address - Fax:727-669-2540
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP950142363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY041POtherBLUE CROSS BLUE SHIELD
FL302030400Medicaid