Provider Demographics
NPI:1992809461
Name:NOLAND, SHARON S (APRN)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:S
Last Name:NOLAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:SUE
Other - Last Name:STOCKARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:KY
Mailing Address - Zip Code:40336-0510
Mailing Address - Country:US
Mailing Address - Phone:912-481-3395
Mailing Address - Fax:
Practice Address - Street 1:240 MAIN ST
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:KY
Practice Address - Zip Code:40336-1026
Practice Address - Country:US
Practice Address - Phone:843-300-2385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-130094363L00000X
SC21218363L00000X
MDR174728363LF0000X
GARN154825363LF0000X
KY3002507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-130094OtherALABAMA BOARD OF NURSING
GARN154825OtherGEORGIA LICENSURE ADVANCED PRACTICE NURSING
KY3002507OtherKY BON
SCNP5237Medicaid