Provider Demographics
NPI:1083924252
Name:CATLEDGE, SHARON WILSON (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:WILSON
Last Name:CATLEDGE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:PLANTERSVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38862-0219
Mailing Address - Country:US
Mailing Address - Phone:662-842-4877
Mailing Address - Fax:662-842-4330
Practice Address - Street 1:2464 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLANTERSVILLE
Practice Address - State:MS
Practice Address - Zip Code:38862-5002
Practice Address - Country:US
Practice Address - Phone:662-842-4877
Practice Address - Fax:662-842-4330
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR738347363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner