Provider Demographics
NPI:1164456265
Name:ARMSTRONG, SHARON ROSE (NP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ROSE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-5205
Mailing Address - Country:US
Mailing Address - Phone:810-987-6200
Mailing Address - Fax:
Practice Address - Street 1:1225 10TH ST
Practice Address - Street 2:HURON FAMILY PRACTICE CENTER
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060
Practice Address - Country:US
Practice Address - Phone:810-987-6200
Practice Address - Fax:810-987-8717
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704159570363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4963616Medicaid
MIS76980Medicare UPIN
MIG44570006Medicare PIN