Provider Demographics
NPI:1134274194
Name:SHARPE, CHARLES RODNEY II (APRN)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:RODNEY
Last Name:SHARPE
Suffix:II
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2527 E PARKSIDE LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85024-7575
Mailing Address - Country:US
Mailing Address - Phone:480-910-4160
Mailing Address - Fax:480-546-3203
Practice Address - Street 1:2527 E PARKSIDE LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-7575
Practice Address - Country:US
Practice Address - Phone:480-910-4160
Practice Address - Fax:480-546-3203
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN207955163W00000X
AZ247414363LP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse