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NPI Code Detail

MEDICARE: MRS. SHARON DENISE WHITE FNP

MEDICARE: MRS. SHARON DENISE WHITE FNP
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 Practitioner2012009566MO

General Provider Information

NPI Number : 1215293378
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARON DENISE WHITE FNP
Provider Business Mailing Address
First Line : 806 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1512
Country : US
Telephone Number : 573-276-3873
Fax Number : 573-276-4212
Provider Business Practice Location Address
First Line : 806 N DOUGLASS ST
Second Line :
City : MALDEN
State : MO
Zip : 63863-1512
Country : US
Telephone Number : 573-276-3873
Fax Number : 573-276-4212
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2012
Last Update Date : 09/22/2020

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