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General NPI Number Information
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NPI Number | 1740233683
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Entity Type | Individual
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Provider Name | SHARON A NICOSON NP
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Gender | Female
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 10/13/2023
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Provider Practice Location Address
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Address Line | 1542 S BLOOMINGTON ST
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City | GREENCASTLE
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State | IN
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Zip | 46135-2212
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Country | US
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Telephone | 765-301-7625
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Fax |
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Provider Business Mailing Address
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Address Line | 1542 S BLOOMINGTON ST
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City | GREENCASTLE
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State | IN
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Zip | 46135-2212
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Country | US
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Telephone | 765-301-7625
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 71000973A
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License Number State | IN
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