MEDICARE: SHARON A NICOSON 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	363LA2100X	Acute Care Nurse Practitioner	71000973A	IN

General Provider Information

NPI Number	:	1740233683
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON A NICOSON NP

Provider Business Mailing Address
First Line	:	1542 S BLOOMINGTON ST
Second Line	:
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-2212
Country	:	US
Telephone Number	:	765-301-7625
Fax Number	:

Provider Business Practice Location Address
First Line	:	1542 S BLOOMINGTON ST
Second Line	:
City	:	GREENCASTLE
State	:	IN
Zip	:	46135-2212
Country	:	US
Telephone Number	:	765-301-7625
Fax Number	:

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	10/13/2023

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