Provider Demographics
NPI:1295836542
Name:DYE, SHARLETTE NMN (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:MRS
First Name:SHARLETTE
Middle Name:NMN
Last Name:DYE
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:4612 GLENARM RD
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-9587
Mailing Address - Country:US
Mailing Address - Phone:502-287-5307
Mailing Address - Fax:502-287-6988
Practice Address - Street 1:800 ZORN AVE
Practice Address - Street 2:C&P DEPT
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1433
Practice Address - Country:US
Practice Address - Phone:502-287-5307
Practice Address - Fax:502-287-6988
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KY1036511363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical