Provider Demographics
NPI:1033189204
Name:JOLENE J. SHARRETT
Entity Type:Organization
Organization Name:JOLENE J. SHARRETT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OB/GYN NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:719-524-4773
Mailing Address - Street 1:902 TARI DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-2255
Mailing Address - Country:US
Mailing Address - Phone:719-488-5868
Mailing Address - Fax:719-488-5869
Practice Address - Street 1:USA MEDDAC, EVANS ARMY COMMUNITY HOSPITAL
Practice Address - Street 2:1650 COCHRANE CIRCLE, ATTN: CREDENTIALS OFFICE
Practice Address - City:FORT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913-4604
Practice Address - Country:US
Practice Address - Phone:719-526-7844
Practice Address - Fax:719-526-7984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO114234286500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes286500000XHospitalsMilitary Hospital