Basic Information
| Provider Information | |||||||||
| NPI: | 1407815699 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHERWIN | ||||||||
| FirstName: | BARBARA | ||||||||
| MiddleName: | JO | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | FNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SHINN | ||||||||
| OtherFirstName: | BARBARA | ||||||||
| OtherMiddleName: | JO | ||||||||
| OtherNamePrefix: | MRS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | RN | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 31 SYCAMORE DR | ||||||||
| Address2: | PO BOX 667 | ||||||||
| City: | MALONE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12953 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184815123 | ||||||||
| FaxNumber: | 5184830115 | ||||||||
| Practice Location | |||||||||
| Address1: | 155 FINNEY BLVD | ||||||||
| Address2: | CP OF THE NORTH COUNTRY | ||||||||
| City: | MALONE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12953 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5184830109 | ||||||||
| FaxNumber: | 5184830115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | X | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 334274 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.