Provider Demographics
NPI:1972571867
Name:EDWARDS, SHARON (ARNP,CS)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:ARNP,CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 23823
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40523
Mailing Address - Country:US
Mailing Address - Phone:859-278-8772
Mailing Address - Fax:859-422-4361
Practice Address - Street 1:2901 S LYNNHAVEN RD STE 450
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-8524
Practice Address - Country:US
Practice Address - Phone:757-536-2246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2023-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4296S364SP0808X
VA0024174312364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000371930OtherBCBS CKBH
KY78011988Medicaid
1211023OtherCHA CKBH
P00295305OtherRAILROAD MED. CKBH
1211023OtherCHA CKBH
KYR64952Medicare UPIN
KY0947801Medicare ID - Type UnspecifiedCKBH