Healthcare Provider Details

I. General information

NPI: 1922154228
Provider Name (Legal Business Name): SHARON RENEE ALLEN RN, MSN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2007
Last Update Date: 09/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3569 RIDGE RD
CLEVELAND OH
44102-5443
US

IV. Provider business mailing address

20950 NICHOLAS AVE
EUCLID OH
44123-3023
US

V. Phone/Fax

Practice location:
  • Phone: 216-281-0872
  • Fax:
Mailing address:
  • Phone: 216-543-9968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number318644
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15123-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: