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NPI Code Detail

MEDICARE: SHIRL G. EARON NURSE PRACTIONER

MEDICARE: SHIRL G. EARON NURSE PRACTIONER
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
1363LF0000XFamily Nurse Practitioner14426CA
2163WW0000XWound Care Registered NurseNP144260CA

General Provider Information

NPI Number : 1194702548
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIRL G. EARON NURSE PRACTIONER
Provider Business Mailing Address
First Line : 4860 Y ST
Second Line : STE 3500
City : SACRAMENTO
State : CA
Zip : 95817-2307
Country : US
Telephone Number : 916-734-6498
Fax Number : 916-734-8094
Provider Business Practice Location Address
First Line : 4860 Y ST
Second Line : STE 2200
City : SACRAMENTO
State : CA
Zip : 95817-2307
Country : US
Telephone Number : 916-734-2222
Fax Number : 916-734-7676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2005
Last Update Date : 11/18/2021

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Directions to “ SHIRL G. EARON NURSE PRACTIONER” Practice Location

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