Provider Demographics
NPI:1780830075
Name:WALTERS, SHARON ANGELA (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ANGELA
Last Name:WALTERS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 SKYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-1427
Mailing Address - Country:US
Mailing Address - Phone:845-454-1458
Mailing Address - Fax:845-473-6692
Practice Address - Street 1:30 SKYVIEW DR
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-1427
Practice Address - Country:US
Practice Address - Phone:845-454-1458
Practice Address - Fax:845-473-6692
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY494547-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse