Provider Demographics
NPI:1508115866
Name:DIMOND, SHARON MARIE (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:DIMOND
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:MARIE
Other - Last Name:LANNON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:179 FOOSHEE PASS
Mailing Address - Street 2:
Mailing Address - City:TEN MILE
Mailing Address - State:TN
Mailing Address - Zip Code:37880-5023
Mailing Address - Country:US
Mailing Address - Phone:423-605-6944
Mailing Address - Fax:
Practice Address - Street 1:2208 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:TN
Practice Address - Zip Code:37303-1626
Practice Address - Country:US
Practice Address - Phone:423-745-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-02
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16937363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily