Provider Demographics
NPI:1093297822
Name:OLIVER, SHARON DARLENE (RN, WOCRN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DARLENE
Last Name:OLIVER
Suffix:
Gender:F
Credentials:RN, WOCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:NM
Mailing Address - Zip Code:88426-9835
Mailing Address - Country:US
Mailing Address - Phone:575-487-2252
Mailing Address - Fax:
Practice Address - Street 1:301 N 2ND ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:NM
Practice Address - Zip Code:88426-9835
Practice Address - Country:US
Practice Address - Phone:575-487-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR38361163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool