Provider Demographics
NPI:1922126150
Name:LITTLE, SHARON HICKS (FNP)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:HICKS
Last Name:LITTLE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:JEAN
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:910 MADISON AVE
Mailing Address - Street 2:SUITE 922
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103-3403
Mailing Address - Country:US
Mailing Address - Phone:901-448-5630
Mailing Address - Fax:901-448-7255
Practice Address - Street 1:910 MADISON AVE, SUITE 922
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38163
Practice Address - Country:US
Practice Address - Phone:901-448-5630
Practice Address - Fax:901-448-7255
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2015-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006098363L00000X
TNRN0000071386163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse