Healthcare Provider Details

I. General information

NPI: 1407943061
Provider Name (Legal Business Name): SHARMAN TYBRING MOSES MS RN CS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 TER HEUN DR GOSNOLD THORNE COUNSELING CTR
FALMOUTH MA
02540
US

IV. Provider business mailing address

3 COLT LANE
PLYMOUTH MA
02360
US

V. Phone/Fax

Practice location:
  • Phone: 508-563-2262
  • Fax: 508-563-2660
Mailing address:
  • Phone: 508-833-2782
  • Fax: 508-563-2262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number163695PC
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: