Provider Demographics
NPI:1447424510
Name:SHARPE, TRIVIA GRIFFIN (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:TRIVIA
Middle Name:GRIFFIN
Last Name:SHARPE
Suffix:
Gender:F
Credentials:FNP-BC
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 16545
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-6545
Mailing Address - Country:US
Mailing Address - Phone:866-347-4580
Mailing Address - Fax:919-967-6647
Practice Address - Street 1:557 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-4107
Practice Address - Country:US
Practice Address - Phone:704-878-4985
Practice Address - Fax:704-878-7463
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5003918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2593247Medicare UPIN