MEDICARE: SHARON FENNIMORE MA, E-RYT, RPYT

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	374J00000X	Doula

General Provider Information

NPI Number	:	1487099396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON FENNIMORE MA, E-RYT, RPYT

Provider Business Mailing Address
First Line	:	PO BOX 81061
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-0561
Country	:	US
Telephone Number	:	412-855-5692
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 BUTLER ST
Second Line	:	C/O SHINING LIGHT DOULAS
City	:	PITTSBURGH
State	:	PA
Zip	:	15201-1847
Country	:	US
Telephone Number	:	412-855-5692
Fax Number	:

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

Provider Enumeration Date	:	05/06/2013
Last Update Date	:	05/22/2015

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