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Individual

MS. STACY JO SHERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
725 WASHBURN WAY, KLAMATH FALLS, OR 97603-3648
(541) 883-1030
(541) 884-2338
Mailing address
2210 ELDORADO AVE., KLAMTH FALLS, OR 97601-6418
(541) 883-1030
(541) 884-2338

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19809
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
223354
OR
Enumeration date
12/03/2010
Last updated
03/12/2014
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