Healthcare Provider Details

I. General information

NPI: 1861307928
Provider Name (Legal Business Name): SHARLY PARKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 CHURCH STREET UNIT 51
NORFOLK VA
23501
US

IV. Provider business mailing address

3060 MAPLETON AVE
NORFOLK VA
23504-3870
US

V. Phone/Fax

Practice location:
  • Phone: 757-776-1849
  • Fax:
Mailing address:
  • Phone: 757-776-1849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: