Healthcare Provider Details

I. General information

NPI: 1487099396
Provider Name (Legal Business Name): SHARON FENNIMORE MA, E-RYT, RPYT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 BUTLER ST C/O SHINING LIGHT DOULAS
PITTSBURGH PA
15201-1847
US

IV. Provider business mailing address

PO BOX 81061
PITTSBURGH PA
15217-0561
US

V. Phone/Fax

Practice location:
  • Phone: 412-855-5692
  • Fax:
Mailing address:
  • Phone: 412-855-5692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: