MEDICARE: MARY ANN M SHARPE APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	26NN03666900	NJ

General Provider Information

NPI Number	:	1023231438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY ANN M SHARPE APN

Provider Business Mailing Address
First Line	:	905 TICE PL
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2628
Country	:	US
Telephone Number	:	908-654-0568
Fax Number	:

Provider Business Practice Location Address
First Line	:	MONTCLAIR STATE UNIVERSITY
Second Line	:
City	:	MONTCLAIR
State	:	NJ
Zip	:	07043-1624
Country	:	US
Telephone Number	:	973-655-4361
Fax Number	:	973-655-4159

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	11/23/2025

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