Provider Demographics
NPI:1306027743
Name:NORD, SHARON (P T)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:NORD
Suffix:
Gender:F
Credentials:P T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7915 LAKE MANASSAS DR STE 305
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3260
Mailing Address - Country:US
Mailing Address - Phone:571-248-0248
Mailing Address - Fax:571-248-0250
Practice Address - Street 1:8100 ASHTON AVE STE 209
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-5688
Practice Address - Country:US
Practice Address - Phone:571-379-5285
Practice Address - Fax:571-379-5283
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305211666208100000X
MD21814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1679630073OtherFACILITY NPI NUMBER
VA1952558918OtherGROUP NPI
MD283MS009OtherMEDICARE PTAN