MEDICARE: TAEGHAN RENEE WARD SHARPE

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1902731623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAEGHAN RENEE WARD SHARPE

Provider Business Mailing Address
First Line	:	2526 CARLTON DR
Second Line	:
City	:	LAWRENCE
State	:	KS
Zip	:	66046-5544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 W BASELINE RD STE 140
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85202-5821
Country	:	US
Telephone Number	:	638-716-7864
Fax Number	:

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

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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