Provider Demographics
NPI:1831530427
Name:SHERIDAN, JERRICA D (CRNP)
Entity type:Individual
Prefix:
First Name:JERRICA
Middle Name:D
Last Name:SHERIDAN
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:JERRICA
Other - Middle Name:
Other - Last Name:LYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:53 SAVITZ RD
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-7176
Mailing Address - Country:US
Mailing Address - Phone:757-373-5922
Mailing Address - Fax:
Practice Address - Street 1:1401 ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-2244
Practice Address - Country:US
Practice Address - Phone:717-851-1405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171421363L00000X
DC1061504363LF0000X
MARN2374072363LF0000X
NJ26NJ01259600363LF0000X
MI4704368834363LF0000X
FLAPRN11026520363LF0000X
PASP012965363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner