Provider Demographics
NPI:1114676707
Name:MERRITT-WATSON, SHARON LANETTE
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LANETTE
Last Name:MERRITT-WATSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 ABERLOUR DR
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-8185
Mailing Address - Country:US
Mailing Address - Phone:919-333-5584
Mailing Address - Fax:
Practice Address - Street 1:712 BULTMAN DR STE C
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-2553
Practice Address - Country:US
Practice Address - Phone:803-526-1952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCIHCP-16263747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant