Provider Demographics
NPI:1184138869
Name:SHARP, KRYSTAL GAIL (RN)
Entity type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:GAIL
Last Name:SHARP
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:KRYSTAL
Other - Middle Name:GAIL
Other - Last Name:PONTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1395 EISENHOWER DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3901
Mailing Address - Country:US
Mailing Address - Phone:912-356-2441
Mailing Address - Fax:912-721-6919
Practice Address - Street 1:1395 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3901
Practice Address - Country:US
Practice Address - Phone:912-356-2441
Practice Address - Fax:912-721-6919
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN270095163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health