Provider Demographics
NPI:1255769279
Name:SHARP, KYRA LORAINE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KYRA
Middle Name:LORAINE
Last Name:SHARP
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 CHANEY RD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:KY
Mailing Address - Zip Code:42134-5108
Mailing Address - Country:US
Mailing Address - Phone:270-850-9736
Mailing Address - Fax:
Practice Address - Street 1:2508 SCOTTSVILLE RD STE 104
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-4400
Practice Address - Country:US
Practice Address - Phone:270-746-6330
Practice Address - Fax:270-904-6337
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-30
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3008233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily