Healthcare Provider Details

I. General information

NPI: 1285461830
Provider Name (Legal Business Name): LAUREN SHARP PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2024
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 S SAGINAW ST STE D
GRAND BLANC MI
48439-8126
US

IV. Provider business mailing address

10801 S SAGINAW ST STE D
GRAND BLANC MI
48439-8126
US

V. Phone/Fax

Practice location:
  • Phone: 810-771-4074
  • Fax: 810-662-0672
Mailing address:
  • Phone: 810-771-4074
  • Fax: 810-662-0672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704355029
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: