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General NPI Number Information
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NPI Number | 1740749167
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Entity Type | Individual
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Provider Name | JESSICA RAE SHARP DPT
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Gender | Female
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 9405 BRYANT FARMS RD
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City | CHARLOTTE
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State | NC
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Zip | 28277-1642
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Country | US
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Telephone | 980-207-2707
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Fax | 980-207-2783
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Provider Business Mailing Address
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Address Line | 1429 BRYANT ST STE A
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City | CHARLOTTE
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State | NC
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Zip | 28208-5201
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Country | US
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Telephone | 704-919-0867
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Fax | 704-817-8579
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | LAT-4847
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | P24596
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License Number State | NC
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