Provider Demographics
NPI:1851713044
Name:SMITH, SHARON DENISE (APRN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DENISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27500 TINKERS VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2147
Mailing Address - Country:US
Mailing Address - Phone:440-439-1951
Mailing Address - Fax:
Practice Address - Street 1:6100 ROCKSIDE WOODS BLVD N
Practice Address - Street 2:STE 425
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2366
Practice Address - Country:US
Practice Address - Phone:216-643-2780
Practice Address - Fax:216-524-0111
Is Sole Proprietor?:No
Enumeration Date:2014-01-08
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 15290-NP363LG0600X
OH15290363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology