Provider Demographics
NPI:1376964577
Name:WILKERSON, SHARON RISING (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:RISING
Last Name:WILKERSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10195 BEACH DR SW STE 5
Mailing Address - Street 2:
Mailing Address - City:CALABASH
Mailing Address - State:NC
Mailing Address - Zip Code:28467-2757
Mailing Address - Country:US
Mailing Address - Phone:910-575-0884
Mailing Address - Fax:910-575-0197
Practice Address - Street 1:10195 BEACH DR SW STE 5
Practice Address - Street 2:
Practice Address - City:CALABASH
Practice Address - State:NC
Practice Address - Zip Code:28467-2757
Practice Address - Country:US
Practice Address - Phone:910-575-0884
Practice Address - Fax:910-575-0197
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006657363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily