MEDICARE: GAYLENE SHARP APRN, NP-C

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	363LF0000X	Family Nurse Practitioner	2013021218	MO

General Provider Information

NPI Number	:	1144660846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAYLENE SHARP APRN, NP-C

Provider Business Mailing Address
First Line	:	PO BOX 84
Second Line	:
City	:	ROGERSVILLE
State	:	MO
Zip	:	65742-0084
Country	:	US
Telephone Number	:	417-861-1710
Fax Number	:	844-201-0108

Provider Business Practice Location Address
First Line	:	8820 COLUMBIA 100 PKWY
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-2163
Country	:	US
Telephone Number	:	417-861-1710
Fax Number	:	844-201-0108

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

Provider Enumeration Date	:	06/27/2013
Last Update Date	:	08/13/2025

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