Provider Demographics
NPI:1578839023
Name:SHARP, TRUDY (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:TRUDY
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 SE CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-1679
Mailing Address - Country:US
Mailing Address - Phone:509-386-7052
Mailing Address - Fax:
Practice Address - Street 1:694 W ROSE ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2707
Practice Address - Country:US
Practice Address - Phone:509-529-4676
Practice Address - Fax:509-525-1058
Is Sole Proprietor?:No
Enumeration Date:2012-03-29
Last Update Date:2023-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60273475363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily