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General NPI Number Information
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NPI Number | 1003724428
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Entity Type | Individual
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Provider Name | JAYDE SHARP RN
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Gender | Male
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Dates
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Enumeration Date | 08/28/2026
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Last Update Date | 08/28/2026
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Provider Practice Location Address
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Address Line | 1801 FULLER RD
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City | MERIDIAN
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State | MS
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Zip | 39309-5003
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Country | US
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Telephone | 601-679-2039
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Fax | 601-679-3232
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Provider Business Mailing Address
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Address Line | 1801 FULLER RD
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City | MERIDIAN
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State | MS
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Zip | 39309-5003
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Country | US
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Telephone | 601-679-2039
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Fax | 601-679-3232
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | R867003
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License Number State | MS
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