Provider Demographics
NPI:1164414587
Name:WEST, SHARON FRAN (APN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:FRAN
Last Name:WEST
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 405827
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-5800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 HUMPHREYS CENTER DR STE 330
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-2363
Practice Address - Country:US
Practice Address - Phone:901-752-6131
Practice Address - Fax:901-751-6170
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7471363LF0000X
MS81-0108363LF0000X
ARA01556ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00123577Medicaid
AR143724758Medicaid
TN3905522Medicaid
AR143724758Medicaid
S98882Medicare UPIN
MS500000787Medicare PIN
MS00123577Medicaid
MS00123577Medicaid
AR3B016C422Medicare PIN