Provider Demographics
NPI:1922643790
Name:MASON, SHARON Y (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:Y
Last Name:MASON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 CHESTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:VA
Mailing Address - Zip Code:22508-3131
Mailing Address - Country:US
Mailing Address - Phone:571-316-8039
Mailing Address - Fax:
Practice Address - Street 1:1467 CHESTERFIELD RD
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:VA
Practice Address - Zip Code:22508-3131
Practice Address - Country:US
Practice Address - Phone:571-316-8039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-15
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
VA0001222411163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Single Specialty