Provider Demographics
NPI:1013916832
Name:CHRISTOPHER, SHARON ELAINE (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:ELAINE
Last Name:CHRISTOPHER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 ORA DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32506-9505
Mailing Address - Country:US
Mailing Address - Phone:251-971-1028
Mailing Address - Fax:251-971-1029
Practice Address - Street 1:1613 N MCKENZIE ST
Practice Address - Street 2:
Practice Address - City:FOLEY
Practice Address - State:AL
Practice Address - Zip Code:36535-2247
Practice Address - Country:US
Practice Address - Phone:251-971-1028
Practice Address - Fax:251-971-1029
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN1626562367500000X
AL1057643163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCH009956420Medicaid
AL430065532Medicaid