MEDICARE: SHAUNA SHERIDAN

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	363LA2100X	Acute Care Nurse Practitioner	SP034969	PA

General Provider Information

NPI Number	:	1356294904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAUNA SHERIDAN

Provider Business Mailing Address
First Line	:	809 LORAINE ST
Second Line	:
City	:	ARDMORE
State	:	PA
Zip	:	19003-3017
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	333 COTTMAN AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19111-2497
Country	:	US
Telephone Number	:	888-369-2427
Fax Number	:

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

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ SHAUNA SHERIDAN ” Practice Location

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