Healthcare Provider Details

I. General information

NPI: 1396509758
Provider Name (Legal Business Name): SHARP PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 E RICKERT AVE
DICKSON TN
37055-1333
US

IV. Provider business mailing address

207 E RICKERT AVE
DICKSON TN
37055-1333
US

V. Phone/Fax

Practice location:
  • Phone: 629-932-5437
  • Fax: 629-932-4549
Mailing address:
  • Phone: 615-260-5589
  • Fax: 629-932-4549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KELLEY J SHARP
Title or Position: NURSE PRACTITIONER PEDIATRICS
Credential: NP
Phone: 615-260-5589