Provider Demographics
NPI:1205826294
Name:EDWARDS, SHARON ROSE (NP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ROSE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7025 N PLEASANT AVE
Mailing Address - Street 2:#115
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-7031
Mailing Address - Country:US
Mailing Address - Phone:559-266-9906
Mailing Address - Fax:559-266-0906
Practice Address - Street 1:5640 N FRESNO ST
Practice Address - Street 2:#110
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-6098
Practice Address - Country:US
Practice Address - Phone:559-266-9906
Practice Address - Fax:559-266-0906
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2013-04-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CARN303370 NP7553363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP84447Medicare UPIN
CAZZZ25745ZMedicare ID - Type Unspecified