Provider Demographics
NPI:1245574813
Name:CURRY, SHARA MARIAM (LPN)
Entity Type:Individual
Prefix:
First Name:SHARA
Middle Name:MARIAM
Last Name:CURRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 CARTAGO DR
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-8424
Mailing Address - Country:US
Mailing Address - Phone:517-582-1071
Mailing Address - Fax:
Practice Address - Street 1:5850 CARTAGO DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-8424
Practice Address - Country:US
Practice Address - Phone:517-582-1071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703098352164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse