Provider Demographics
NPI:1467475038
Name:SHARP, CRISTY VIRGINIA (APRN, FNP)
Entity Type:Individual
Prefix:
First Name:CRISTY
Middle Name:VIRGINIA
Last Name:SHARP
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:CRISTY
Other - Middle Name:VIRGINIA
Other - Last Name:HERRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3025 DOWLEN RD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-7291
Mailing Address - Country:US
Mailing Address - Phone:409-347-8277
Mailing Address - Fax:409-347-7551
Practice Address - Street 1:3025 DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-7291
Practice Address - Country:US
Practice Address - Phone:409-347-8277
Practice Address - Fax:409-347-7551
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN096244163W00000X
ARR77796163W00000X
LAAP04463363L00000X
ARA02959ANP363LF0000X
TX791310163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1463728Medicaid
OK200106270AMedicaid
AR163952758Medicaid
4H166OtherMEDICARE
AR5A256Medicare PIN
Q25494Medicare UPIN