Provider Demographics
NPI:1821861238
Name:SHARPE, JACQUELYN MCLEAN (LAC, LMT)
Entity Type:Individual
Prefix:MS
First Name:JACQUELYN
Middle Name:MCLEAN
Last Name:SHARPE
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 FURMAN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5038
Mailing Address - Country:US
Mailing Address - Phone:828-264-4521
Mailing Address - Fax:
Practice Address - Street 1:136 FURMAN RD STE 1
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5038
Practice Address - Country:US
Practice Address - Phone:828-264-4521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8233225700000X
NC992171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist