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General NPI Number Information
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NPI Number | 1720218431
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Entity Type | Individual
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Provider Name | REBECCA LYNN GRINSELL SHERIDAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 4076 NEELY RD
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City | FT. WAINWRIGHT
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State | AK
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Zip | 99703
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Country | US
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Telephone | 907-361-6153
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Fax | 907-361-4809
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Provider Business Mailing Address
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Address Line | BASSETT ARMY COMMUNITY HOSPITAL 4076 NEELY ROAD
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City | FT. WAINWRIGHT
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State | AK
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Zip | 99703
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Country | US
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Telephone | 907-361-5356
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Fax | 907-361-4809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101249803
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License Number State | VA
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