Provider Demographics
NPI:1912566928
Name:MELTON, SHARON DELOISE (APRN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:DELOISE
Last Name:MELTON
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 1:4312 HOLIDAY INN EXPRESSWAY
Mailing Address - Street 2:STE 102
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37343
Mailing Address - Country:US
Mailing Address - Phone:423-331-5200
Mailing Address - Fax:423-250-3686
Practice Address - Street 1:1100 SHALLOWFORD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-1623
Practice Address - Country:US
Practice Address - Phone:423-596-7170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN174525163W00000X
TN26040363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse