Provider Demographics
NPI:1790019602
Name:WELLS-SHARP, ANNA (NP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:WELLS-SHARP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 PENNINGTON DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:BLUFFTON
Mailing Address - State:SC
Mailing Address - Zip Code:29910-9041
Mailing Address - Country:US
Mailing Address - Phone:843-757-5559
Mailing Address - Fax:843-757-5546
Practice Address - Street 1:48 PENNINGTON DR
Practice Address - Street 2:SUITE C
Practice Address - City:BLUFFTON
Practice Address - State:SC
Practice Address - Zip Code:29910-9041
Practice Address - Country:US
Practice Address - Phone:843-757-5559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2010-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1514363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAA45709125Medicare UPIN