Healthcare Provider Details
I. General information
NPI: 1831335256
Provider Name (Legal Business Name): REBECCA ANN SHERIDAN PT, INHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/07/2009
Last Update Date: 02/23/2025
Certification Date: 02/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
18376 SOUTHAMPTON DR
LEWES DE
19958-3266
US
IV. Provider business mailing address
18376 SOUTHAMPTON DR
LEWES DE
19958-3266
US
V. Phone/Fax
- Phone: 336-897-8087
- Fax:
- Phone: 336-897-8087
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374K00000X |
| Taxonomy | Religious Nonmedical Practitioner |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | J1-0014618 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: