Provider Demographics
NPI:1245313279
Name:HARTZOG, SHARON POWERS (RN)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:POWERS
Last Name:HARTZOG
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:284 EXECUTIVE PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-1831
Mailing Address - Country:US
Mailing Address - Phone:704-939-1100
Mailing Address - Fax:704-939-1173
Practice Address - Street 1:132 POPLAR GROVE CONNECTOR
Practice Address - Street 2:SUITE B
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5915
Practice Address - Country:US
Practice Address - Phone:828-264-8759
Practice Address - Fax:828-262-5687
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2013-07-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC188644163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGOtherTRICARE PROVIDER ID #