Provider Demographics
NPI:1073969796
Name:SUAN, SHARON (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:SUAN
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 LAURELWOOD DR
Mailing Address - Street 2:APT D
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-3080
Mailing Address - Country:US
Mailing Address - Phone:575-769-2389
Mailing Address - Fax:
Practice Address - Street 1:3728 N PRINCE ST
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-9744
Practice Address - Country:US
Practice Address - Phone:575-769-2389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-11
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMIN00003469183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist