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General NPI Number Information
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NPI Number | 1295769578
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Entity Type | Individual
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Provider Name | JESSICA SHARP FNP
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Gender | Female
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 04/10/2013
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Provider Practice Location Address
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Address Line | 1710 HARPER RD
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City | BECKLEY
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State | WV
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Zip | 25801-3357
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Country | US
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Telephone | 304-254-3101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 634715
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City | CINCINNATI
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State | OH
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Zip | 45263-0001
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Country | US
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Telephone |
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 22714
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3007160
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License Number State | KY
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