Provider Demographics
NPI:1598044026
Name:ANDERSON, SHARON (CRNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6490 LANDOVER RD
Mailing Address - Street 2:SUITE # G
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1443
Mailing Address - Country:US
Mailing Address - Phone:301-322-1117
Mailing Address - Fax:301-322-1757
Practice Address - Street 1:6490 LANDOVER RD
Practice Address - Street 2:SUITE # G
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1443
Practice Address - Country:US
Practice Address - Phone:301-322-1117
Practice Address - Fax:301-322-1757
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN65927363LF0000X
MDR135181363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily