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NPI Code Detail

MEDICARE: CLARA SHARP CD, CPE, CBE

MEDICARE: CLARA SHARP CD, CPE, CBE
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
1374J00000XDoula

General Provider Information

NPI Number : 1962875278
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLARA SHARP CD, CPE, CBE
Provider Business Mailing Address
First Line : 3018 51ST AVE N
Second Line :
City : BROOKLYN CENTER
State : MN
Zip : 55429-3454
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1901 44TH AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1209
Country : US
Telephone Number : 763-516-6148
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2015
Last Update Date : 11/09/2015

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