Healthcare Provider Details

I. General information

NPI: 1619280476
Provider Name (Legal Business Name): THERESA E SHARP DNP, PMHNP-BC, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2010
Last Update Date: 05/27/2020
Certification Date: 05/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N 12TH ST
READING PA
19604-1545
US

IV. Provider business mailing address

191 DOGWOOD DR
BERNVILLE PA
19506-9400
US

V. Phone/Fax

Practice location:
  • Phone: 610-816-5728
  • Fax:
Mailing address:
  • Phone: 610-334-9339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN608888
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP021200
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: