Provider Demographics
NPI:1790898039
Name:POWELL, SHARON MARGARET (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:MARGARET
Last Name:POWELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6536
Mailing Address - Street 2:
Mailing Address - City:FRAZIER PARK
Mailing Address - State:CA
Mailing Address - Zip Code:93222-6536
Mailing Address - Country:US
Mailing Address - Phone:661-242-2592
Mailing Address - Fax:661-242-2590
Practice Address - Street 1:16233 ASKIN DR.
Practice Address - Street 2:SUITE A
Practice Address - City:FRAZIER PARK
Practice Address - State:CA
Practice Address - Zip Code:93222-6536
Practice Address - Country:US
Practice Address - Phone:661-242-2592
Practice Address - Fax:661-248-5279
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP14217363L00000X
CA14217363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner