Healthcare Provider Details

I. General information

NPI: 1700639259
Provider Name (Legal Business Name): KATHRYN ANN SHARPLES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 S MAIN ST STE 150
JAMESTOWN NY
14701-6627
US

IV. Provider business mailing address

15 S MAIN ST STE 150
JAMESTOWN NY
14701-6627
US

V. Phone/Fax

Practice location:
  • Phone: 716-483-6700
  • Fax: 716-664-7275
Mailing address:
  • Phone: 716-483-6700
  • Fax: 716-664-7275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number032649
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: