Provider Demographics
NPI:1093837320
Name:CAIN, SHARON ALICIA (APRN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ALICIA
Last Name:CAIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:A
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1701 SE HILLMOOR DR STE 7
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34952-7552
Mailing Address - Country:US
Mailing Address - Phone:772-480-5860
Mailing Address - Fax:772-264-8310
Practice Address - Street 1:1701 SE HILLMOOR DR STE 7
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-7552
Practice Address - Country:US
Practice Address - Phone:772-480-5860
Practice Address - Fax:772-264-8310
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN1297891164W00000X
FLAPRN11005819363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No164W00000XNursing Service ProvidersLicensed Practical Nurse