Provider Demographics
NPI:1851706972
Name:SHARP, JENNIE BARBARA (NP)
Entity Type:Individual
Prefix:MRS
First Name:JENNIE
Middle Name:BARBARA
Last Name:SHARP
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JENNIE
Other - Middle Name:BARBARA
Other - Last Name:DOBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3104 CREEKSIDE VILLAGE DR NW STE 504
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2393
Mailing Address - Country:US
Mailing Address - Phone:770-966-0778
Mailing Address - Fax:
Practice Address - Street 1:3104 CREEKSIDE VILLAGE DR NW STE 504
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2393
Practice Address - Country:US
Practice Address - Phone:770-966-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN192158363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics