Healthcare Provider Details

I. General information

NPI: 1043274483
Provider Name (Legal Business Name): SHARON K. HARMON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHARON K KENDALL

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 WELLNESS BLVD SUITE 110
IRMO SC
29063-2871
US

IV. Provider business mailing address

4010 FISH HATCHERY RD
GASTON SC
29053-9489
US

V. Phone/Fax

Practice location:
  • Phone: 843-839-5995
  • Fax:
Mailing address:
  • Phone: 808-218-4161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN 3647
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: