Provider Demographics
NPI:1679011548
Name:HIXENBAUGH, SHARON MARIE (CRNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARIE
Last Name:HIXENBAUGH
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 1:1300 FORT PIERPONT DRIVE SUITE 101
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508
Mailing Address - Country:US
Mailing Address - Phone:304-241-7150
Mailing Address - Fax:304-554-2106
Practice Address - Street 1:4422 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:AVELLA
Practice Address - State:PA
Practice Address - Zip Code:15312-2121
Practice Address - Country:US
Practice Address - Phone:724-345-3784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCNP020400363LF0000X
PASP016948363LF0000X
WVAPRN63459363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily