MEDICARE: JO ANNA SHARP

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	224Z00000X	Occupational Therapy Assistant	163168	KY

General Provider Information

NPI Number	:	1578226973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JO ANNA SHARP

Provider Business Mailing Address
First Line	:	733 PALMETTO LOOP
Second Line	:
City	:	GLENDALE
State	:	KY
Zip	:	42740-8320
Country	:	US
Telephone Number	:	270-287-7010
Fax Number	:

Provider Business Practice Location Address
First Line	:	733 PALMETTO LOOP
Second Line	:
City	:	GLENDALE
State	:	KY
Zip	:	42740-8320
Country	:	US
Telephone Number	:	270-287-7010
Fax Number	:

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

Provider Enumeration Date	:	10/21/2021
Last Update Date	:	10/21/2021

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Directions to “ JO ANNA SHARP ” Practice Location

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