Provider Demographics
NPI:1699912840
Name:WOOD, SHERRI KAY (RN NP-C)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:KAY
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 IL 37
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:62426-4020
Mailing Address - Country:US
Mailing Address - Phone:618-922-9382
Mailing Address - Fax:
Practice Address - Street 1:1011 FORD AVE
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401
Practice Address - Country:US
Practice Address - Phone:217-347-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041-235287163W00000X
IL209.007003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse