Provider Demographics
NPI:1710975719
Name:TAGGART, SHARON LYNN (MSN WHNP-BC, ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LYNN
Last Name:TAGGART
Suffix:
Gender:F
Credentials:MSN WHNP-BC, ARNP
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:LYNN
Other - Last Name:LILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RNC NAC WHNP
Mailing Address - Street 1:1970 TROSPER RD SW P202
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512
Mailing Address - Country:US
Mailing Address - Phone:765-427-1021
Mailing Address - Fax:
Practice Address - Street 1:402 LEGION WAY STE 201
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501
Practice Address - Country:US
Practice Address - Phone:360-754-5522
Practice Address - Fax:360-754-5793
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71001499A363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN28066301AOtherRN
IN71001499AOtherNURSE PRACTITIONER
IN100338490Medicaid
IN28066301AOtherRN
IN71001499AOtherNURSE PRACTITIONER