Provider Demographics
NPI:1891155446
Name:HULL, SHARON D (CNA)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:D
Last Name:HULL
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 SOUTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38111-3210
Mailing Address - Country:US
Mailing Address - Phone:901-825-5786
Mailing Address - Fax:
Practice Address - Street 1:3195 SOUTHERN AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38111-3210
Practice Address - Country:US
Practice Address - Phone:901-825-5786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-24
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN135281376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide