Provider Demographics
NPI:1417546474
Name:BRELLIS, SHARON JEAN (RN)
Entity Type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:JEAN
Last Name:BRELLIS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:JEAN
Other - Last Name:BRELLIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:12066 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-3268
Mailing Address - Country:US
Mailing Address - Phone:954-610-3716
Mailing Address - Fax:
Practice Address - Street 1:12066 NW 27TH ST
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-3268
Practice Address - Country:US
Practice Address - Phone:954-610-3716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9224867163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse