Provider Demographics
NPI:1831105733
Name:THORPE, SHARON E (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:E
Last Name:THORPE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E BOND AVE
Mailing Address - Street 2:
Mailing Address - City:WEST MEMPHIS
Mailing Address - State:AR
Mailing Address - Zip Code:72301-3550
Mailing Address - Country:US
Mailing Address - Phone:870-735-3842
Mailing Address - Fax:870-732-1940
Practice Address - Street 1:215 E BOND AVE
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-3550
Practice Address - Country:US
Practice Address - Phone:870-735-3842
Practice Address - Fax:870-732-1940
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMDRN0000113240207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3703214Medicaid
TN3349848Medicare ID - Type Unspecified
P98070Medicare UPIN