Healthcare Provider Details

I. General information

NPI: 1235110636
Provider Name (Legal Business Name): SHERRY BRYANT WOODS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 NOTTINGHAM LN
BOERNE TX
78006-7912
US

IV. Provider business mailing address

621 UPPER TURTLE CREEK RD
KERRVILLE TX
78028-8517
US

V. Phone/Fax

Practice location:
  • Phone: 830-537-4078
  • Fax: 830-537-4082
Mailing address:
  • Phone: 830-792-4683
  • Fax: 830-537-4082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number195059
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: