MEDICARE: NICHOLE SHERWOOD RPH, PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	2019030637	MO

General Provider Information

NPI Number	:	1063063204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE SHERWOOD RPH, PHARMD

Provider Business Mailing Address
First Line	:	1712 NE AUBURN DR
Second Line	:
City	:	LEES SUMMIT
State	:	MO
Zip	:	64086-5927
Country	:	US
Telephone Number	:	816-985-1488
Fax Number	:

Provider Business Practice Location Address
First Line	:	1314 24TH AVENUE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37212
Country	:	US
Telephone Number	:	816-985-1488
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2019
Last Update Date	:	02/12/2026

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