Provider Demographics
NPI:1689740425
Name:TAYLOR SMALLS, SHARON ANN (CNM)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:ANN
Last Name:TAYLOR SMALLS
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:ANN
Other - Last Name:SMALLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1042 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5428
Mailing Address - Country:US
Mailing Address - Phone:347-663-1700
Mailing Address - Fax:347-663-1711
Practice Address - Street 1:1042 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226
Practice Address - Country:US
Practice Address - Phone:347-663-1700
Practice Address - Fax:347-663-1711
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-24
Last Update Date:2018-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF0012301367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife