Provider Demographics
NPI:1407492176
Name:SHARP, ROBIN
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 38
Mailing Address - Street 2:
Mailing Address - City:EMINENCE
Mailing Address - State:IN
Mailing Address - Zip Code:46125-0038
Mailing Address - Country:US
Mailing Address - Phone:765-469-5908
Mailing Address - Fax:
Practice Address - Street 1:6554 N FORREST ST
Practice Address - Street 2:
Practice Address - City:EMINENCE
Practice Address - State:IN
Practice Address - Zip Code:46125
Practice Address - Country:US
Practice Address - Phone:176-546-9590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN19-014322372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion