Provider Demographics
NPI:1558310987
Name:PARRIS, SHARON ROSE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ROSE
Last Name:PARRIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 965
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-0965
Mailing Address - Country:US
Mailing Address - Phone:931-879-4645
Mailing Address - Fax:931-879-2606
Practice Address - Street 1:101 S DUNCAN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3007
Practice Address - Country:US
Practice Address - Phone:931-879-4645
Practice Address - Fax:931-879-2606
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13461363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3902772Medicaid
TN3902772Medicaid
TNS80979Medicare UPIN