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General NPI Number Information
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NPI Number | 1851862684
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Entity Type | Individual
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Provider Name | SHARON ANN WALLIS CNM, APRN
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Gender | Female
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Dates
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Enumeration Date | 12/05/2018
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Last Update Date | 12/05/2018
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Provider Practice Location Address
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Address Line | 306 STONERIDGE BLVD
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City | ASHEVILLE
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State | NC
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Zip | 28804-8313
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Country | US
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Telephone | 828-337-0753
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Fax |
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Provider Business Mailing Address
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Address Line | 12 LARCHMONT RD
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City | ASHEVILLE
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State | NC
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Zip | 28804-2413
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Country | US
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Telephone | 828-337-0753
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 711
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License Number State | NC
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