Provider Demographics
NPI:1447428909
Name:SHARP, AMY DEANE (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:DEANE
Last Name:SHARP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:MELISSA
Other - Last Name:DEANE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 DR. MARTIN LUTHER KING PARKWAY
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37813
Mailing Address - Country:US
Mailing Address - Phone:423-587-1987
Mailing Address - Fax:423-587-9252
Practice Address - Street 1:220 DR. MARTIN LUTHER KING PARKWAY
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37813
Practice Address - Country:US
Practice Address - Phone:423-587-1987
Practice Address - Fax:423-587-9252
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN143810163W00000X, 363LF0000X
TNAPN13320363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341635Medicaid
TN3341635Medicaid