Healthcare Provider Details

I. General information

NPI: 1437731619
Provider Name (Legal Business Name): SHARON ANN CHAMBERS CCMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2021
Last Update Date: 04/27/2021
Certification Date: 04/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ROUTE 108
SOMERSWORTH NH
03878-1119
US

IV. Provider business mailing address

200 ROUTE 108
SOMERSWORTH NH
03878-1119
US

V. Phone/Fax

Practice location:
  • Phone: 603-953-0077
  • Fax: 603-953-0078
Mailing address:
  • Phone: 603-953-0077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: