Provider Demographics
NPI:1578289609
Name:AVERHART, SHARON (LPN)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:AVERHART
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 FAIRHILL RD APT 520
Mailing Address - Street 2:
Mailing Address - City:SHAKER HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44120-5509
Mailing Address - Country:US
Mailing Address - Phone:216-280-1903
Mailing Address - Fax:
Practice Address - Street 1:13800 FAIRHILL RD APT 520
Practice Address - Street 2:
Practice Address - City:SHAKER HTS
Practice Address - State:OH
Practice Address - Zip Code:44120-5509
Practice Address - Country:US
Practice Address - Phone:216-280-1903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH149528164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH149528OtherLPN