Provider Demographics
NPI:1497898407
Name:PAGE, SHARON P (CPNP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:P
Last Name:PAGE
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
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Mailing Address - Street 1:215 HAWKS RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-2708
Mailing Address - Country:US
Mailing Address - Phone:731-681-1577
Mailing Address - Fax:731-681-1532
Practice Address - Street 1:215 HAWKS RD
Practice Address - Street 2:SUITE 3
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-2708
Practice Address - Country:US
Practice Address - Phone:731-681-1577
Practice Address - Fax:731-681-1532
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNAPN 12549363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
APN 12549OtherTN LICENSE
TNRN 105799OtherTN LICENSE