Provider Demographics
NPI:1235269929
Name:DEGROOT, SHARON K (RN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:K
Last Name:DEGROOT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1277 N CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:GALESBURG
Mailing Address - State:IL
Mailing Address - Zip Code:61401-1814
Mailing Address - Country:US
Mailing Address - Phone:309-337-0328
Mailing Address - Fax:
Practice Address - Street 1:387 E GROVE ST
Practice Address - Street 2:
Practice Address - City:GALESBURG
Practice Address - State:IL
Practice Address - Zip Code:61401-3728
Practice Address - Country:US
Practice Address - Phone:309-343-0311
Practice Address - Fax:309-343-0385
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health