Provider Demographics
NPI:1548569536
Name:GERVING, SHARON (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:GERVING
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10751 W OVERLAND RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83709-1375
Mailing Address - Country:US
Mailing Address - Phone:208-373-5233
Mailing Address - Fax:208-373-5227
Practice Address - Street 1:10751 W OVERLAND RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83709-1375
Practice Address - Country:US
Practice Address - Phone:208-373-5233
Practice Address - Fax:208-373-5227
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP6202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist