Provider Demographics
NPI:1114633054
Name:SHARP, BRITTNEE RENE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:BRITTNEE
Middle Name:RENE
Last Name:SHARP
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:BRITTNEE
Other - Middle Name:
Other - Last Name:SHOEMAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:212 CHANTICLEER PL
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-9300
Mailing Address - Country:US
Mailing Address - Phone:575-309-7366
Mailing Address - Fax:
Practice Address - Street 1:2300 N MAIN ST STE 19A
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-3575
Practice Address - Country:US
Practice Address - Phone:575-769-0049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM71651363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM71651OtherAPRN-CNP