Provider Demographics
NPI:1235743220
Name:SHARPE, SHAMEKA MAJEL 'ANNDESHAY
Entity Type:Individual
Prefix:
First Name:SHAMEKA
Middle Name:MAJEL 'ANNDESHAY
Last Name:SHARPE
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 1:1408 WALKER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27412-5020
Mailing Address - Country:US
Mailing Address - Phone:252-289-8298
Mailing Address - Fax:
Practice Address - Street 1:1408 WALKER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412-5020
Practice Address - Country:US
Practice Address - Phone:252-289-8298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-07
Last Update Date:2020-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1202XEye and Vision Services ProvidersTechnician/TechnologistOptometric Technician
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic