Provider Demographics
NPI:1528372620
Name:KIRCHHEIMER, SHARON LEIGH IVES (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEIGH IVES
Last Name:KIRCHHEIMER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
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Mailing Address - Street 1:960 E GREEN ST
Mailing Address - Street 2:SUITE 292
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2412
Mailing Address - Country:US
Mailing Address - Phone:626-449-4494
Mailing Address - Fax:626-449-4474
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:SUITE 292
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2412
Practice Address - Country:US
Practice Address - Phone:626-449-4494
Practice Address - Fax:626-449-4474
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP19300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily