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NPI Code Detail

MEDICARE: LEANN K SHARP APN

MEDICARE:   LEANN K SHARP  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
12080P0006XDevelopmental - Behavioral Pediatrics Physician71005012AIN
2363L00000XNurse Practitioner71005012AIN
3363L00000XNurse Practitioner209-006773IL
4363LP0808XPsychiatric/Mental Health Nurse Practitioner71005012AIN

General Provider Information

NPI Number : 1275703803
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANN K SHARP APN
Provider Business Mailing Address
First Line : 709 S 18TH ST
Second Line :
City : LAFAYETTE
State : IN
Zip : 47905-1575
Country : US
Telephone Number : 765-709-0500
Fax Number : 317-718-8438
Provider Business Practice Location Address
First Line : 709 S 18TH ST
Second Line :
City : LAFAYETTE
State : IN
Zip : 47905-1575
Country : US
Telephone Number : 765-709-0500
Fax Number : 317-718-8438
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2008
Last Update Date : 08/28/2023

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