Healthcare Provider Details

I. General information

NPI: 1821387325
Provider Name (Legal Business Name): SHARON MARIE HOOPER PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHARON HOOPER WALTER PA

II. Dates (important events)

Enumeration Date: 04/05/2011
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 HERLONG CT STE C
ROCK HILL SC
29732-1193
US

IV. Provider business mailing address

200 HERLONG AVE S STE E
ROCK HILL SC
29732-1182
US

V. Phone/Fax

Practice location:
  • Phone: 704-335-9794
  • Fax:
Mailing address:
  • Phone: 803-366-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number1644
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0010-02811
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: