Provider Demographics
NPI:1609274240
Name:SHARPE, SERENA WESTMORELAND (RPH)
Entity Type:Individual
Prefix:MRS
First Name:SERENA
Middle Name:WESTMORELAND
Last Name:SHARPE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:SERENA
Other - Middle Name:YVONNE
Other - Last Name:WESTMORELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-713-5442
Mailing Address - Fax:336-713-3472
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-713-5442
Practice Address - Fax:336-713-3472
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-14
Last Update Date:2014-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11478183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist