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NPI Code Detail

MEDICARE: MRS. SHARON BOURDON GANEY CRNP

MEDICARE: MRS. SHARON BOURDON GANEY CRNP
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
1208VP0000XPain Medicine Physician1-125908AL
2363LF0000XFamily Nurse PractitionerARNP 9375017FL
3363L00000XNurse Practitioner1-125908AL

General Provider Information

NPI Number : 1932521374
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARON BOURDON GANEY CRNP
Provider Business Mailing Address
First Line : 30762 STATE HIGHWAY 181
Second Line :
City : SPANISH FORT
State : AL
Zip : 36527-5672
Country : US
Telephone Number : 251-626-0732
Fax Number :
Provider Business Practice Location Address
First Line : 30762 STATE HIGHWAY 181
Second Line :
City : SPANISH FORT
State : AL
Zip : 36527-5672
Country : US
Telephone Number : 251-626-0732
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2014
Last Update Date : 09/16/2021

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