Provider Demographics
NPI:1144793696
Name:LEVENTHAL, SHARON LYNN (APRN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:LEVENTHAL
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 HOSPITAL DR STE 280
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-2456
Mailing Address - Country:US
Mailing Address - Phone:386-437-4711
Mailing Address - Fax:386-437-4772
Practice Address - Street 1:21 HOSPITAL DR STE 280
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-2456
Practice Address - Country:US
Practice Address - Phone:386-437-4711
Practice Address - Fax:386-437-4772
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1952402363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health