MEDICARE: SANDRA ATWOOD APRN-BC

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	163W00000X	Registered Nurse	RN2262015	MA
2	363LF0000X	Family Nurse Practitioner	AP11808P	VI

General Provider Information

NPI Number	:	1790098796
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA ATWOOD APRN-BC

Provider Business Mailing Address
First Line	:	5000 ESTATE ENIGHED
Second Line	:	PMB 311
City	:	ST JOHN
State	:	VI
Zip	:	00830-6120
Country	:	US
Telephone Number	:	340-714-4270
Fax Number	:

Provider Business Practice Location Address
First Line	:	481-2 CHOCOLATE HOLE
Second Line	:
City	:	ST JOHN
State	:	VI
Zip	:	00830-6120
Country	:	US
Telephone Number	:	340-714-4270
Fax Number	:

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

Provider Enumeration Date	:	07/19/2010
Last Update Date	:	06/24/2025

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