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General NPI Number Information
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NPI Number | 1518657345
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Entity Type | Individual
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Provider Name | SHARON LYNN ELEBY
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Gender | Female
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 05/15/2023
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Provider Practice Location Address
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Address Line | 235 WELLESLEY ST
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City | WESTON
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State | MA
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Zip | 02493-1572
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Country | US
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Telephone | 301-910-7040
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6084
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City | JBER
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State | AK
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Zip | 99506-6084
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Country | US
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Telephone | 301-910-7040
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 192050
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License Number State | AK
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