Provider Demographics
NPI:1740771898
Name:SHARP-MARSDEN, ELIZABETH ANN (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:SHARP-MARSDEN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2272 ENELL ST
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83402-2910
Mailing Address - Country:US
Mailing Address - Phone:208-313-7900
Mailing Address - Fax:
Practice Address - Street 1:2275 CHANNING WAY
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-8012
Practice Address - Country:US
Practice Address - Phone:208-900-3434
Practice Address - Fax:208-701-6272
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ID53940363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty