Provider Demographics
NPI:1912187352
Name:SHARP-SAUNDERS, JENNIFER L (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:L
Last Name:SHARP-SAUNDERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:L
Other - Last Name:RHODES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5000 MONARCH PT
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-4275
Mailing Address - Country:US
Mailing Address - Phone:423-798-6630
Mailing Address - Fax:423-798-6633
Practice Address - Street 1:5000 MONARCH PT
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745-4275
Practice Address - Country:US
Practice Address - Phone:423-798-6630
Practice Address - Fax:423-798-6633
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1980208000000X
WAMD60271005208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154061905Medicaid
WA1912187352Medicaid