Healthcare Provider Details

I. General information

NPI: 1699196865
Provider Name (Legal Business Name): SHARON CHANG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2013
Last Update Date: 02/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

690 BARNES BLVD
LEWIS MCCHORD WA
98438
US

IV. Provider business mailing address

6895 E SUNRISE DRIVE
TUCSON AZ
85750
US

V. Phone/Fax

Practice location:
  • Phone: 253-982-5601
  • Fax:
Mailing address:
  • Phone: 520-615-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP9571
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: