MEDICARE: SHARON DENISE ROSS NP

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	363L00000X	Nurse Practitioner	0001162224	VA

General Provider Information

NPI Number	:	1699042879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON DENISE ROSS NP

Provider Business Mailing Address
First Line	:	PO BOX 40065
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-0065
Country	:	US
Telephone Number	:	303-831-6686
Fax Number	:	720-932-9255

Provider Business Practice Location Address
First Line	:	21 SPURS LN STE 245
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1689
Country	:	US
Telephone Number	:	210-487-7463
Fax Number	:	210-487-7468

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

Provider Enumeration Date	:	11/16/2011
Last Update Date	:	03/15/2017

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