Provider Demographics
NPI:1871863332
Name:SHERWOOD, JENNIFER MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:MARIE
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 N DUKE ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602
Mailing Address - Country:US
Mailing Address - Phone:951-743-9869
Mailing Address - Fax:
Practice Address - Street 1:201 ROCK LITITZ BOULEVARD
Practice Address - Street 2:SUITE 14
Practice Address - City:LITITZ
Practice Address - State:PA
Practice Address - Zip Code:17543-1369
Practice Address - Country:US
Practice Address - Phone:951-743-9869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055379363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant