Provider Demographics
NPI:1568680098
Name:MINOR, SHARON LEE (MS, DSIII)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LEE
Last Name:MINOR
Suffix:
Gender:F
Credentials:MS, DSIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PINNACLE DR SE
Mailing Address - Street 2:APT. 2523
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-3682
Mailing Address - Country:US
Mailing Address - Phone:505-934-9446
Mailing Address - Fax:
Practice Address - Street 1:201 PINNACLE DR SE
Practice Address - Street 2:APT. 2523
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3682
Practice Address - Country:US
Practice Address - Phone:505-934-9446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-22
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDSIII373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist