Provider Demographics
NPI:1023204138
Name:MERRYMAN, SHARON BONITA
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:BONITA
Last Name:MERRYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 REGENCY LN
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-3062
Mailing Address - Country:US
Mailing Address - Phone:423-543-5652
Mailing Address - Fax:423-543-5652
Practice Address - Street 1:609 REGENCY LN
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-3062
Practice Address - Country:US
Practice Address - Phone:423-543-5652
Practice Address - Fax:423-543-5652
Is Sole Proprietor?:No
Enumeration Date:2007-09-21
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000057012163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management