Provider Demographics
NPI:1114597556
Name:SHARMA, MINI (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MINI
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2178 MENDON RD STE 325
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-3846
Mailing Address - Country:US
Mailing Address - Phone:774-454-3088
Mailing Address - Fax:
Practice Address - Street 1:2178 MENDON RD STE 325
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-3846
Practice Address - Country:US
Practice Address - Phone:774-454-3088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RICAPRN03829363LP0808X
MARN2269112163WP0808X, 363LP0808X
RIRN75752163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health