Provider Demographics
NPI:1639133713
Name:WALTERS, SHARON (RN, CNS, PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:WALTERS
Suffix:
Gender:F
Credentials:RN, CNS, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1604 HOSPITAL PKWY STE 507
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-6933
Mailing Address - Country:US
Mailing Address - Phone:469-774-2823
Mailing Address - Fax:817-354-9930
Practice Address - Street 1:1604 HOSPITAL PKWY
Practice Address - Street 2:SUITE 507
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6986
Practice Address - Country:US
Practice Address - Phone:817-354-7268
Practice Address - Fax:817-354-9930
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4-23299363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health