Provider Demographics
NPI:1710086293
Name:HART, SHARON (ARNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:HART
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11745
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34101-1745
Mailing Address - Country:US
Mailing Address - Phone:239-776-9671
Mailing Address - Fax:239-330-7385
Practice Address - Street 1:5067 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-4128
Practice Address - Country:US
Practice Address - Phone:239-776-9671
Practice Address - Fax:239-330-7385
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3097622163WA0400X, 163WP0808X, 163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE5391FMedicare PIN
FLP29584Medicare UPIN