Provider Demographics
NPI:1801373956
Name:NOOKS, SHARON LYNN
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LYNN
Last Name:NOOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 OUTER BELLE RD APT B
Mailing Address - Street 2:
Mailing Address - City:TROTWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45426-1523
Mailing Address - Country:US
Mailing Address - Phone:937-520-7674
Mailing Address - Fax:
Practice Address - Street 1:101 OUTER BELLE RD APT B
Practice Address - Street 2:
Practice Address - City:TROTWOOD
Practice Address - State:OH
Practice Address - Zip Code:45426-1523
Practice Address - Country:US
Practice Address - Phone:937-520-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-22
Last Update Date:2018-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRR642450251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health