Provider Demographics
NPI:1518399005
Name:SHARPE, TIPHNE NICHELLE (APN)
Entity Type:Individual
Prefix:
First Name:TIPHNE
Middle Name:NICHELLE
Last Name:SHARPE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 W 203RD ST
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA FIELDS
Mailing Address - State:IL
Mailing Address - Zip Code:60461-1180
Mailing Address - Country:US
Mailing Address - Phone:708-679-1890
Mailing Address - Fax:708-747-9859
Practice Address - Street 1:3700 W 203RD ST
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1180
Practice Address - Country:US
Practice Address - Phone:708-679-1890
Practice Address - Fax:708-747-9859
Is Sole Proprietor?:No
Enumeration Date:2013-08-06
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.010530363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health