Healthcare Provider Details

I. General information

NPI: 1477980233
Provider Name (Legal Business Name): JOANNA O SHARP NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2013
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18-20 LACKAWANNA PLZ
MONTCLAIR NJ
07042-3642
US

IV. Provider business mailing address

18-20 LACKAWANNA PLZ STE 300
MONTCLAIR NJ
07042-3642
US

V. Phone/Fax

Practice location:
  • Phone: 973-604-8376
  • Fax:
Mailing address:
  • Phone: 973-604-8376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number26NJ00461600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ00461600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: