Healthcare Provider Details

I. General information

NPI: 1801247978
Provider Name (Legal Business Name): SHERRI L GWINN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2016
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 KATES MOUNTAIN RD
WHITE SULPHUR SPRINGS WV
24986-2381
US

IV. Provider business mailing address

167 KATES MOUNTAIN RD
WHITE SULPHUR SPRINGS WV
24986-2381
US

V. Phone/Fax

Practice location:
  • Phone: 304-536-8018
  • Fax: 304-536-8018
Mailing address:
  • Phone: 304-536-8018
  • Fax: 304-536-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberWV68868APRN
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: