Healthcare Provider Details

I. General information

NPI: 1992424279
Provider Name (Legal Business Name): SALLY DAY SHARP PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1776 HIGHWAY 49 S
FLORENCE MS
39073-9429
US

IV. Provider business mailing address

1776 HIGHWAY 49 S
FLORENCE MS
39073-9429
US

V. Phone/Fax

Practice location:
  • Phone: 601-825-6010
  • Fax: 601-825-7146
Mailing address:
  • Phone: 601-825-6010
  • Fax: 601-825-7146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number905536
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: