Healthcare Provider Details

I. General information

NPI: 1851713044
Provider Name (Legal Business Name): SHARON DENISE SMITH APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2014
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 ROCKSIDE WOODS BLVD N STE 425
INDEPENDENCE OH
44131-2366
US

IV. Provider business mailing address

27500 TINKERS VALLEY DR
SOLON OH
44139-2147
US

V. Phone/Fax

Practice location:
  • Phone: 216-643-2780
  • Fax: 216-524-0111
Mailing address:
  • Phone: 440-439-1951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberCOA 15290-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number15290
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: