Provider Demographics
NPI:1194461277
Name:HARRIS, SHARON L
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:L
Last Name:HARRIS
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 1:1653 HIGHWAY 581
Mailing Address - Street 2:
Mailing Address - City:ULYSSES
Mailing Address - State:KY
Mailing Address - Zip Code:41264-9046
Mailing Address - Country:US
Mailing Address - Phone:304-785-8119
Mailing Address - Fax:
Practice Address - Street 1:1 TIMBERWOLF LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25704-9377
Practice Address - Country:US
Practice Address - Phone:304-429-1699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV57726163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool