Provider Demographics
NPI:1164011375
Name:APPLE, SHARON KAY
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KAY
Last Name:APPLE
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 1:3201 MCCLELLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804
Mailing Address - Country:US
Mailing Address - Phone:417-347-6337
Mailing Address - Fax:417-347-6336
Practice Address - Street 1:3201 MCCLLELAND BLVD.
Practice Address - Street 2:STE. B
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-6480
Practice Address - Country:US
Practice Address - Phone:417-347-6337
Practice Address - Fax:417-347-6336
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO042373183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist