Provider Demographics
NPI:1891912192
Name:SMITH, SHARON (CRNP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2741 SAM HILL RD
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17329-9277
Mailing Address - Country:US
Mailing Address - Phone:717-633-9808
Mailing Address - Fax:410-516-4784
Practice Address - Street 1:3400 N CHARLES ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2608
Practice Address - Country:US
Practice Address - Phone:410-516-8270
Practice Address - Fax:410-516-4784
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR090330363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health