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NPI Code Detail

MEDICARE: CAROLYN M SHERIDAN APRN

MEDICARE:   CAROLYN M SHERIDAN  APRN
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
1363LF0000XFamily Nurse Practitioner317778AZ

General Provider Information

NPI Number : 1427867688
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN M SHERIDAN APRN
Provider Business Mailing Address
First Line : 5830 W THUNDERBIRD RD STE B8
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-4655
Country : US
Telephone Number : 602-429-9807
Fax Number :
Provider Business Practice Location Address
First Line : 5830 W THUNDERBIRD RD STE B8
Second Line :
City : GLENDALE
State : AZ
Zip : 85306-4655
Country : US
Telephone Number : 602-429-9807
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2025
Last Update Date : 01/02/2025

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Directions to “ CAROLYN M SHERIDAN APRN” Practice Location

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