MEDICARE: SHARON F MARSHALL RN GNP CS BC

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	364SG0600X	Gerontology Clinical Nurse Specialist	513451	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00041932	OTHER	TX	PGA RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	NP0371	OTHER	TX	BC/BS OF TEXAS

General Provider Information

NPI Number	:	1164404463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON F MARSHALL RN GNP CS BC

Provider Business Mailing Address
First Line	:	3723 WILLOW SPRINGS DR
Second Line	:
City	:	MANVEL
State	:	TX
Zip	:	77578-4787
Country	:	US
Telephone Number	:	832-264-2133
Fax Number	:	281-412-4690

Provider Business Practice Location Address
First Line	:	3723 WILLOW SPRINGS DR
Second Line	:
City	:	MANVEL
State	:	TX
Zip	:	77578-4787
Country	:	US
Telephone Number	:	832-264-2133
Fax Number	:	281-412-4690

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

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	06/18/2008

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