Provider Demographics
NPI:1760693089
Name:CRAFT, SHARON (DNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:CRAFT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12388 WARWICK BLVD
Mailing Address - Street 2:STE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-3857
Mailing Address - Country:US
Mailing Address - Phone:757-223-7810
Mailing Address - Fax:757-223-7856
Practice Address - Street 1:12388 WARWICK BLVD
Practice Address - Street 2:STE 303
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-3857
Practice Address - Country:US
Practice Address - Phone:757-223-7810
Practice Address - Fax:757-223-7856
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-25
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0710101452101YA0400X
VA0017139162363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1760693089Medicaid
VAVV96310281Medicare PIN
VA022526P73Medicare PIN