Provider Demographics
NPI:1841367000
Name:SHERIDAN, WILHELMINA MARIE (FNP)
Entity type:Individual
Prefix:
First Name:WILHELMINA
Middle Name:MARIE
Last Name:SHERIDAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:WILHELMINA
Other - Middle Name:MARIE
Other - Last Name:TUFANO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:133 PARK ST FL 2
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1244
Mailing Address - Country:US
Mailing Address - Phone:518-651-2184
Mailing Address - Fax:518-651-2183
Practice Address - Street 1:134 PARK ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1259
Practice Address - Country:US
Practice Address - Phone:518-481-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY331107363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03187280Medicaid