Provider Demographics
NPI:1710555875
Name:SHARRAS, YANNICK
Entity Type:Individual
Prefix:
First Name:YANNICK
Middle Name:
Last Name:SHARRAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 ABBEY RD
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-8042
Mailing Address - Country:US
Mailing Address - Phone:470-830-3811
Mailing Address - Fax:
Practice Address - Street 1:113 ALBRIGHT AVE E
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88103-5163
Practice Address - Country:US
Practice Address - Phone:470-830-3811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical