MEDICARE: SHARNET BOOTHE

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	163W00000X	Registered Nurse	RN304423	GA

General Provider Information

NPI Number	:	1184894529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARNET BOOTHE

Provider Business Mailing Address
First Line	:	7344 STONE BLUFF DR
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30134-3776
Country	:	US
Telephone Number	:	954-309-7549
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 MARIETTA ST NW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-2861
Country	:	US
Telephone Number	:	404-963-7531
Fax Number	:	404-963-7531

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

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	05/08/2025

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Directions to “ SHARNET BOOTHE ” Practice Location

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