Provider Demographics
NPI:1467665810
Name:HEDLUND, SHARON ANN (FNP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:ANN
Last Name:HEDLUND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:SHARON
Other - Middle Name:ANN
Other - Last Name:LORENTZEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 121
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:ND
Mailing Address - Zip Code:58723-0121
Mailing Address - Country:US
Mailing Address - Phone:701-626-1655
Mailing Address - Fax:701-352-4515
Practice Address - Street 1:701 W 6TH ST
Practice Address - Street 2:
Practice Address - City:GRAFTON
Practice Address - State:ND
Practice Address - Zip Code:58237-1379
Practice Address - Country:US
Practice Address - Phone:701-352-4389
Practice Address - Fax:701-352-4515
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR11675320600000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NDS95597Medicare UPIN
ND19630Medicare ID - Type Unspecified