Provider Demographics
NPI:1205085362
Name:NICHOLAS, SHARON DEOGRATIAS (RN)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:DEOGRATIAS
Last Name:NICHOLAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:SHARON
Other - Middle Name:DEOGRATIAS
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1195 NW 134TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33168-6637
Mailing Address - Country:US
Mailing Address - Phone:305-769-0509
Mailing Address - Fax:
Practice Address - Street 1:1195 NW 134TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33168-6637
Practice Address - Country:US
Practice Address - Phone:305-769-0509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9214877163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse