Provider Demographics
NPI:1992394597
Name:SHARMA, MOHANIE
Entity Type:Individual
Prefix:MRS
First Name:MOHANIE
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MOHANIE
Other - Middle Name:
Other - Last Name:BHAJAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:2567 METRO PKWY
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-7146
Mailing Address - Country:US
Mailing Address - Phone:586-754-0000
Mailing Address - Fax:
Practice Address - Street 1:2567 METRO PKWY
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-7146
Practice Address - Country:US
Practice Address - Phone:586-754-0000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-18
Last Update Date:2021-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704336201363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily