Provider Demographics
NPI:1598484081
Name:MCPHERSON, SHARA MICHELLE (APRN)
Entity Type:Individual
Prefix:
First Name:SHARA
Middle Name:MICHELLE
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 S BOGGESS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42345-1150
Mailing Address - Country:US
Mailing Address - Phone:270-977-4514
Mailing Address - Fax:
Practice Address - Street 1:3419 WATHENS XING
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-7009
Practice Address - Country:US
Practice Address - Phone:270-926-7565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3017958363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily