Provider Demographics
NPI:1093974214
Name:GORETSKY, SHARON AMY (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:AMY
Last Name:GORETSKY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6025 PROVIDENCE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3808
Mailing Address - Country:US
Mailing Address - Phone:757-474-0600
Mailing Address - Fax:757-474-1903
Practice Address - Street 1:6025 PROVIDENCE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3808
Practice Address - Country:US
Practice Address - Phone:757-474-0600
Practice Address - Fax:757-474-1903
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017139135363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner