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: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3681 OKEMOS RD STE 500
OKEMOS MI
48864-6923
US

IV. Provider business mailing address

3681 OKEMOS RD STE 500
OKEMOS MI
48864-6923
US

V. Phone/Fax

Practice location:
  • Phone: 517-455-7600
  • Fax: 517-441-4764
Mailing address:
  • Phone: 517-455-7600
  • Fax: 517-441-4764

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: