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NPI Code Detail

MEDICARE: SHARON THORSON NP

MEDICARE: SHARON THORSON NP
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 Practitioner1678033WI
2363L00000XNurse Practitioner1678033WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558361238
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON THORSON NP
Provider Business Mailing Address
First Line : PO BOX 88215
Second Line :
City : MILWAUKEE
State : WI
Zip : 53288-0001
Country : US
Telephone Number : 800-968-6866
Fax Number :
Provider Business Practice Location Address
First Line : 1818 N MEADE ST
Second Line :
City : APPLETON
State : WI
Zip : 54911-3454
Country : US
Telephone Number : 800-968-6866
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2005
Last Update Date : 04/20/2008

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