Provider Demographics
NPI:1477958114
Name:BYRD, SHARON (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:BYRD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19251 HIGHWAY 295
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72740-6262
Mailing Address - Country:US
Mailing Address - Phone:479-456-2975
Mailing Address - Fax:479-587-8421
Practice Address - Street 1:107 E MONTE PAINTER DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4002
Practice Address - Country:US
Practice Address - Phone:479-463-7000
Practice Address - Fax:479-587-8421
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-23
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004056363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily