Provider Demographics
NPI:1972193928
Name:FLANAGAN, SHARON LEE
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:LEE
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 EDGEVALE TER
Mailing Address - Street 2:
Mailing Address - City:HARRISONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64701-2613
Mailing Address - Country:US
Mailing Address - Phone:573-836-3612
Mailing Address - Fax:
Practice Address - Street 1:907 EDGEVALE TER
Practice Address - Street 2:
Practice Address - City:HARRISONVILLE
Practice Address - State:MO
Practice Address - Zip Code:64701-2613
Practice Address - Country:US
Practice Address - Phone:573-836-3612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-24
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO119134163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control