Healthcare Provider Details

I. General information

NPI: 1124665203
Provider Name (Legal Business Name): SHARON NICOLE GUERRA DNP, MBA, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 W FARIS RD
GREENVILLE SC
29605-4241
US

IV. Provider business mailing address

975 W FARIS RD
GREENVILLE SC
29605-4241
US

V. Phone/Fax

Practice location:
  • Phone: 864-729-8330
  • Fax:
Mailing address:
  • Phone: 864-729-8330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number30108
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: