MEDICARE: SHARON M NAYLOR FNP-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	363LF0000X	Family Nurse Practitioner	13338	TN
2	363LF0000X	Family Nurse Practitioner	3004566	KY

General Provider Information

NPI Number	:	1396921979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON M NAYLOR FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 336
Second Line	:
City	:	JUNCTION CITY
State	:	KY
Zip	:	40440-0336
Country	:	US
Telephone Number	:	270-943-8202
Fax Number	:

Provider Business Practice Location Address
First Line	:	3115 KY HIGHWAY 698
Second Line	:
City	:	STANFORD
State	:	KY
Zip	:	40484-9441
Country	:	US
Telephone Number	:	270-943-8202
Fax Number	:

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

Provider Enumeration Date	:	01/14/2008
Last Update Date	:	03/17/2018

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