Provider Demographics
NPI:1053121814
Name:SHERWOOD, SHAWN MATTHEW (CRNP)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:MATTHEW
Last Name:SHERWOOD
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:CONNELLSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15425-1957
Mailing Address - Country:US
Mailing Address - Phone:724-570-3232
Mailing Address - Fax:
Practice Address - Street 1:812 RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:CONNELLSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15425-1957
Practice Address - Country:US
Practice Address - Phone:724-570-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031035363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health