Healthcare Provider Details

I. General information

NPI: 1144791856
Provider Name (Legal Business Name): SHARI HEARN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARI GETTY RN

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 12/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 JOHN MUIR DR
BUFFALO NY
14228-1144
US

IV. Provider business mailing address

120 SUNSET DR
HAMBURG NY
14075-4347
US

V. Phone/Fax

Practice location:
  • Phone: 800-543-9399
  • Fax:
Mailing address:
  • Phone: 716-446-3325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number726937
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number726937
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number726937
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: