Provider Demographics
NPI:1043555691
Name:DICKMAN, SHARON MARIE NOLAN (NP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE NOLAN
Last Name:DICKMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:MARIE
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:138 LEADER AVE
Mailing Address - Street 2:SUITE 116E
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40506-9983
Mailing Address - Country:US
Mailing Address - Phone:859-218-6727
Mailing Address - Fax:859-257-1888
Practice Address - Street 1:138 LEADER AVE
Practice Address - Street 2:SUITE 116E
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40506-9983
Practice Address - Country:US
Practice Address - Phone:859-218-6727
Practice Address - Fax:859-257-1888
Is Sole Proprietor?:No
Enumeration Date:2012-12-10
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.14019-NP363LF0000X
KY3008267363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily