Healthcare Provider Details

I. General information

NPI: 1790098796
Provider Name (Legal Business Name): SANDRA ATWOOD APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2010
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481-2 CHOCOLATE HOLE
ST JOHN VI
00830-6120
US

IV. Provider business mailing address

5000 ESTATE ENIGHED PMB 311
ST JOHN VI
00830-6120
US

V. Phone/Fax

Practice location:
  • Phone: 340-714-4270
  • Fax:
Mailing address:
  • Phone: 340-714-4270
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2262015
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP11808P
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: