Healthcare Provider Details

I. General information

NPI: 1093512006
Provider Name (Legal Business Name): SHERI L SHARP FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 PONTIAC AVE
CRANSTON RI
02920-7944
US

IV. Provider business mailing address

420 SCRABBLETOWN RD STE A
NORTH KINGSTOWN RI
02852-3638
US

V. Phone/Fax

Practice location:
  • Phone: 401-895-9937
  • Fax: 855-268-5333
Mailing address:
  • Phone: 401-268-5333
  • Fax: 855-268-5333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN38862
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN04543
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN04543
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: