Provider Demographics
NPI:1508274077
Name:NELSON, SHARON ALLISON (RN)
Entity Type:Individual
Prefix:MISS
First Name:SHARON
Middle Name:ALLISON
Last Name:NELSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232-18 MERRICK BOULEVARD
Mailing Address - Street 2:LAURELTON
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2115
Mailing Address - Country:US
Mailing Address - Phone:718-528-3432
Mailing Address - Fax:718-528-3303
Practice Address - Street 1:232-18 MERRICK BOULEVARD
Practice Address - Street 2:LAURELTON
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11413-2115
Practice Address - Country:US
Practice Address - Phone:718-528-3432
Practice Address - Fax:718-528-3303
Is Sole Proprietor?:No
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY636897-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse