Provider Demographics
NPI:1174839377
Name:ADDY, SHARON N (NP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:N
Last Name:ADDY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:ADDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:8500 FRANCISCAN WOODS DRIVE
Mailing Address - Street 2:APT 1026
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909
Mailing Address - Country:US
Mailing Address - Phone:706-544-2322
Mailing Address - Fax:
Practice Address - Street 1:1549 OLD BRIDGE RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2737
Practice Address - Country:US
Practice Address - Phone:703-436-9009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-25
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN218443363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care