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NPI Code Detail

MEDICARE: LYDIA BEATRICE SHARP

MEDICARE: LYDIA BEATRICE SHARP
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner0024181686VA

General Provider Information

NPI Number : 1679244677
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYDIA BEATRICE SHARP
Provider Business Mailing Address
First Line : 14000 CROWN CT STE 101
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22193-1461
Country : US
Telephone Number : 540-812-2718
Fax Number :
Provider Business Practice Location Address
First Line : 14000 CROWN CT STE 101
Second Line :
City : WOODBRIDGE
State : VA
Zip : 22193-1461
Country : US
Telephone Number : 540-812-2718
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2021
Last Update Date : 09/21/2021

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Directions to “ LYDIA BEATRICE SHARP ” Practice Location

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