MEDICARE: SUZANNE SHERWOOD

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	363LF0000X	Family Nurse Practitioner	1068328	TX

General Provider Information

NPI Number	:	1902552482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE SHERWOOD

Provider Business Mailing Address
First Line	:	10312 COUNTRY SWAN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4405
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10312 COUNTRY SWAN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-4405
Country	:	US
Telephone Number	:	210-744-2344
Fax Number	:

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

Provider Enumeration Date	:	02/23/2022
Last Update Date	:	02/23/2022

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Directions to “ SUZANNE SHERWOOD ” Practice Location

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