Provider Demographics
NPI:1508396235
Name:MCRORIE, SHARON RENEE (NP-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:RENEE
Last Name:MCRORIE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:RENEE
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1739 N SAGINAW ST STE 104A
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-7627
Mailing Address - Country:US
Mailing Address - Phone:810-305-0061
Mailing Address - Fax:810-305-3319
Practice Address - Street 1:1739 N SAGINAW ST STE 104A
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-7627
Practice Address - Country:US
Practice Address - Phone:810-305-0061
Practice Address - Fax:810-305-3319
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704248029363L00000X, 363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0022297Medicaid
MIVS0022297Medicaid