Provider Demographics
NPI:1598773756
Name:HAIRE, SHARON W (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:W
Last Name:HAIRE
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 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:48 CROSS PARK CT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4263
Practice Address - Country:US
Practice Address - Phone:864-797-7400
Practice Address - Fax:864-797-7405
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20479363LP0200X
NH048580-23364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30341364Medicaid
VT0NP3232Medicaid
SCNP4261Medicaid
VT0NP3232Medicaid
SCPENDINGMedicare PIN
NHNP3232Medicare PIN