Healthcare Provider Details

I. General information

NPI: 1467592808
Provider Name (Legal Business Name): SHARON A BARDELE RN BS MSC CRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2007
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 S 90TH ST
WEST ALLIS WI
53227-2455
US

IV. Provider business mailing address

PO BOX 735044
CHICAGO IL
60673-5044
US

V. Phone/Fax

Practice location:
  • Phone: 414-328-8270
  • Fax: 414-328-8275
Mailing address:
  • Phone: 800-326-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4623
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number68311030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: