Provider Demographics
NPI:1275570145
Name:BAROCCO, SHARON L (CRNA)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:L
Last Name:BAROCCO
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:L
Other - Last Name:KNOTTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2117 S ANDOVER RD
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-8697
Mailing Address - Country:US
Mailing Address - Phone:316-733-8166
Mailing Address - Fax:
Practice Address - Street 1:2117 S ANDOVER RD
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:KS
Practice Address - Zip Code:67002-8697
Practice Address - Country:US
Practice Address - Phone:316-733-8166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-40037-122367500000X
FLARNP9360267367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered