Healthcare Provider Details

I. General information

NPI: 1952723678
Provider Name (Legal Business Name): SHARRON M BOATWRIGHT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/15/2014
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29564 US HIGHWAY 189
KEMMERER WY
83101-4018
US

IV. Provider business mailing address

225 VON KARMAN RD BLDG 225
ARNOLD AFB TN
37389-1506
US

V. Phone/Fax

Practice location:
  • Phone: 225-955-7250
  • Fax:
Mailing address:
  • Phone: 931-454-5748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-056150
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number27235
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: