Basic Information
| Provider Information | |||||||||
| NPI: | 1730524760 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHERWOOD | ||||||||
| FirstName: | JANIECE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1145 S UTICA AVE | ||||||||
| Address2: | STE 460 | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741044041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9185795749 | ||||||||
| FaxNumber: | 9185795762 | ||||||||
| Practice Location | |||||||||
| Address1: | 1145 S UTICA AVE STE 460 | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741044041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9185795749 | ||||||||
| FaxNumber: | 9185605791 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2013 | ||||||||
| LastUpdateDate: | 06/20/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364S00000X | 62453 | OK | N | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | 363L00000X | 62453 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.