Provider Demographics
NPI:1730658394
Name:VASS, SHARON O
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:O
Last Name:VASS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-3211
Mailing Address - Country:US
Mailing Address - Phone:972-838-8577
Mailing Address - Fax:
Practice Address - Street 1:809 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3211
Practice Address - Country:US
Practice Address - Phone:972-838-8577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX589034163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse