Healthcare Provider Details

I. General information

NPI: 1457546707
Provider Name (Legal Business Name): SHARON W. FROESE APRN./CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON A FROESE NP, CNM

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2225 CIVIC CENTER DR STE. 230
NORTH LAS VEGAS NV
89030-6338
US

IV. Provider business mailing address

PO BOX 15645
LAS VEGAS NV
89114-5645
US

V. Phone/Fax

Practice location:
  • Phone: 702-854-2953
  • Fax:
Mailing address:
  • Phone: 702-579-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number9223502
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPRN000571
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN34302
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: